Individual
REGINA MARIE WILKENING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
503 N WALNUT ST, BOISE, ID 83712-7344
(208) 559-4538
(208) 345-5458
Mailing address
503 N WALNUT ST, BOISE, ID 83712-7344
(208) 559-4538
(208) 345-5458
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-549
ID
Other
Enumeration date
12/08/2008
Last updated
12/08/2008
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