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1437626124
ELIZABETH RAE LAGAZO
IDAHO FALLS, ID
NPI
1437626124
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Former Name
ELIZABETH RAE MILLER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
222Q00000X Developmental Therapist
Enumeration Date
2018-10-31
Last Update Date
2018-10-31
Business Address
ELIZABETH RAE LAGAZO
150 SHOUP AVE
IDAHO FALLS, ID 83402-3657
Phone number: 208-528-4071
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Mailing Address
ELIZABETH RAE LAGAZO
150 SHOUP AVE
IDAHO FALLS, ID 83402-3657
Phone number: 208-528-4071
Copy
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