Individual
LANMANA PARYS-WOLODKEWITSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
411 W HAYCRAFT AVE STE D4, COEUR D ALENE, ID 83815-8104
(208) 664-2468
Mailing address
411 W HAYCRAFT AVE STE D4, COEUR D ALENE, ID 83815-8104
(208) 664-2468
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT-2020
ID
Other
Enumeration date
01/28/2019
Last updated
01/28/2019
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