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1548811904
STANLEY KEITH WACHOLZ
HAYDEN LAKE, ID
NPI
1548811904
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106E00000X Assistant Behavior Analyst
Additional Taxonomies
106E00000X Assistant Behavior Analyst
Enumeration Date
2019-09-26
Last Update Date
2019-09-26
Business Address
STANLEY KEITH WACHOLZ BS BIS
5723 E DODD RD
HAYDEN LAKE, ID 83835-9376
Phone number: 208-651-8985
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Mailing Address
STANLEY KEITH WACHOLZ BS BIS
5723 E DODD RD
HAYDEN LAKE, ID 83835-9376
Phone number: 208-651-8985
Copy