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Organization
JOURNEY PEDIATRIC THERAPY
Active
Organization
JOURNEY PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARESA BLACK OTR/L (OCCUPATIONAL THERAPIST AND OWNER)
(208) 627-8615
Entity
Organization
Contact information
Practice address
1009 HIGHWAY 2 STE C, SANDPOINT, ID 83864-2713
(208) 627-8615
(208) 441-2641
Mailing address
PO BOX 2476, SANDPOINT, ID 83864-0914
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
—
NULL
225XP0200X
Pediatric Occupational Therapist
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
OT-1405
ID
Other
Enumeration date
09/18/2015
Last updated
06/01/2022
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