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1699029439
BREANNA KRISTINE JENKS
LEWISTON, ID
NPI
1699029439
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: ID 1182)
Enumeration Date
2012-11-01
Last Update Date
2012-11-01
Business Address
-- BREANNA KRISTINE JENKS COTA/L
1014 BURRELL AVE
LEWISTON, ID 83501-5589
Phone number: 208-743-4558
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Mailing Address
-- BREANNA KRISTINE JENKS COTA/L
1291 SYCAMORE ST
CLARKSTON, WA 99403-2201
Phone number:
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