| NPI | 1609032267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY KRIS JAQUES Owner 208-782-2267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ID OT 232) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PTA 2406) |
| 235Z00000X Speech-Language Pathologist, (Licence: ID 12125357) | |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2008-08-04 |