Individual
ABBY GRENDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2831 PANORAMA DR, LEWISTON, ID 83501-1739
(701) 269-1133
Mailing address
2831 PANORAMA DR, LEWISTON, ID 83501-1739
(701) 269-1133
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT 60205352
WA
225X00000X
Occupational Therapist
Primary
OT-1218
ID
Other
Enumeration date
12/03/2013
Last updated
12/03/2013
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