Individual
MICHELLE L BJORNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
4400 E FLAMINGO AVE, NAMPA, ID 83687-9203
(208) 288-4970
(208) 463-3044
Mailing address
217 W GEORGIA AVE, STE 115, NAMPA, ID 83686-6811
(208) 463-3234
(208) 463-3044
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT558
ID
225XH1200X
Hand Occupational Therapist
1020367
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010150172
BLUE SHIELD
ID
01
—
P00218129
RAILROAD MEDICARE
ID
01
—
W1028
BLUE CROSS
ID
Enumeration date
10/21/2005
Last updated
02/09/2010
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