Individual
SHAWN SOREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., O.T. R/L
Contact information
Practice address
68 S BALTIC PL, MERIDIAN, ID 83642-5935
(208) 587-8255
Mailing address
68 S BALTIC PL, MERIDIAN, ID 83642-5935
(208) 587-8255
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1555
ID
225XP0200X
Pediatric Occupational Therapist
1555
ID
Other
Enumeration date
12/22/2015
Last updated
12/22/2015
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