| NPI | 1073798476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAYNA KATHLEEN WILLBANKS Occupational Therapist Owner 208-892-8888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: ID OT-406) |
| Enumeration Date | 2008-01-03 |
| Last Update Date | 2008-01-03 |