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1184234411
BEN L WALTERS
IDAHO FALLS, ID
NPI
1184234411
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TS0200X Psychologist, School
(Licence: ID 563139723)
Enumeration Date
2020-08-02
Last Update Date
2020-08-02
Business Address
BEN L WALTERS Ed.S.
2871 AGNES ST
IDAHO FALLS, ID 83402-5639
Phone number: 208-270-2716
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Mailing Address
BEN L WALTERS Ed.S.
2871 AGNES ST
IDAHO FALLS, ID 83402-5639
Phone number: 208-270-2716
Copy
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