Loban, Andrea

Loban, Andrea is an sole proprietor health care provider with primary practice located at 5049 Fox Creek Hollow , Victor ID 83455-0000. She recently has only one registered license in Agencies / Day Training, Developmentally Disabled Services, which is considered as her primary health care specialty. Loban, Andrea can be contacted via phone (208) 201-3467.

Contact Information

Primary practice address
5049 Fox Creek Hollow Victor ID 83455-0000
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Agencies / Day Training, Developmentally Disabled Services 251C00000X

Profile Details

NPI number 1902205230
LBN Legal business name Loban, Andrea
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 22nd, 2014
Last updated Aug 22nd, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902205230 NPPES
Wyoming Other 127612300 MEDICAID PROVIDER NUMBER

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