KANESHIA JADE NELSON

EAGLE, ID
NPI1730644071
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: ID  OTA-1731)
Enumeration Date2019-01-31
Last Update Date2019-01-31
Business Address
KANESHIA JADE NELSON COTA/L
449 S FITNESS PL
EAGLE, ID 83616-6828
Phone number: 208-957-6301
Mailing Address
KANESHIA JADE NELSON COTA/L
12098 W TIO LEO CT
BOISE, ID 83709-2289
Phone number: 208-317-1146
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