Individual
JENNY SUE BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
449 S FITNESS PL, EAGLE, ID 83616-6828
(208) 957-6301
Mailing address
5940 W PORT LN APT 103, BOISE, ID 83703-4892
(208) 317-6268
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-2976
ID
Other
Enumeration date
11/06/2024
Last updated
11/06/2024
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