Individual
KIMBERLY ANNE DANNHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1410 S BROADWAY AVE, BOISE, ID 83706-3706
(208) 949-3481
(208) 629-1611
Mailing address
1410 S BROADWAY AVE, BOISE, ID 83706-3706
(208) 949-3481
(208) 629-1611
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-1449
ID
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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