Individual
LISA HARTIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
267 E SCHMEIZER LN, BOISE, ID 83706-4025
(208) 587-0921
Mailing address
267 E SCHMEIZER LN, BOISE, ID 83706-4025
(208) 587-0921
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT-757
ID
Other
Enumeration date
08/31/2015
Last updated
08/31/2015
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