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1154598027
AUTUMN B DEDA
COEUR D ALENE, ID
NPI
1154598027
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: ID OT-868)
Enumeration Date
2008-05-09
Last Update Date
2008-05-09
Business Address
AUTUMN B DEDA
500 W AQUA AVE
COEUR D ALENE, ID 83815-7764
Phone number: 208-762-1122
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Mailing Address
AUTUMN B DEDA
1937 W HAMPSON AVE
COEUR D ALENE, ID 83815-0407
Phone number: 509-220-7338
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