Individual
SUSSETTE HIERS NEWSOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2173 S GEKELER LN, BOISE, ID 83706-4337
(208) 333-8751
Mailing address
2173 S GEKELER LN, BOISE, ID 83706-4337
(208) 333-8751
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
561
ID
Other
Enumeration date
06/15/2016
Last updated
06/15/2016
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