Individual
AUTUMN B DEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W AQUA AVE, COEUR D ALENE, ID 83815-7764
(208) 762-1122
Mailing address
1937 W HAMPSON AVE, COEUR D ALENE, ID 83815-0407
(509) 220-7338
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-868
ID
Other
Enumeration date
05/09/2008
Last updated
05/09/2008
About Stedi
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