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1578262184
MIKAYLA JACQUELYN LACKEY
BOISE, ID
NPI
1578262184
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2023-03-02
Last Update Date
2023-03-02
Business Address
MIKAYLA JACQUELYN LACKEY
3076 N FIVE MILE RD
BOISE, ID 83713-5215
Phone number: 208-252-6531
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Mailing Address
MIKAYLA JACQUELYN LACKEY
3076 N FIVE MILE RD
BOISE, ID 83713-5215
Phone number: 208-252-6531
Copy
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