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1689429342
CODY LEONARD FERNOW
BOISE, ID
NPI
1689429342
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2024-04-17
Last Update Date
2024-04-17
Business Address
Mr. CODY LEONARD FERNOW
1087 E PARK BLVD SUITE 100
BOISE, ID 83712-7722
Phone number: 208-369-3168
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Mailing Address
Mr. CODY LEONARD FERNOW
2718 N GREENVILLE AVE
KUNA, ID 83634-5254
Phone number: 208-914-4849
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