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1790166122
KRISILEE KAY CRUZ
IDAHO FALLS, ID
NPI
1790166122
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ID 10228)
Enumeration Date
2015-06-11
Last Update Date
2015-06-11
Business Address
-- KRISILEE KAY CRUZ ISAS
2275 W BROADWAY ST STE G
IDAHO FALLS, ID 83402-2902
Phone number: 208-524-7400
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Mailing Address
-- KRISILEE KAY CRUZ ISAS
2275 W BROADWAY ST STE G
IDAHO FALLS, ID 83402-2902
Phone number: 208-524-7400
Copy
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