Individual
LAURA K BRUNELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
3080 E GENTRY WAY STE 180, MERIDIAN, ID 83642-3014
(208) 939-3334
Mailing address
2257 N ASTAIRE WAY, MERIDIAN, ID 83646-3807
(208) 891-7104
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
1525
ID
Other
Enumeration date
09/23/2020
Last updated
09/23/2020
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