| NPI | 1033986294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED RICKS Owner/Occupational Therapist 208-360-9969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics |
| Enumeration Date | 2023-12-07 |
| Last Update Date | 2023-12-07 |