Individual
DANA BINGAMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3171 S BOWN WAY, BOISE, ID 83706-5665
(208) 433-9152
Mailing address
3387 N CURT DR, MERIDIAN, ID 83646-5507
(208) 371-4402
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-1026
ID
Other
Enumeration date
08/19/2013
Last updated
08/19/2013
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