Organization
ADA THERAPY SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA CRAIG OT (PROVIDER, OWNER)
(208) 908-6116
Entity
Organization
Contact information
Practice address
4696 W OVERLAND RD STE 232, BOISE, ID 83705-2864
(208) 908-6116
(208) 908-0486
Mailing address
4696 W OVERLAND RD STE 232, BOISE, ID 83705-2864
(208) 908-6116
(208) 908-0486
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-1345
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT-1345
STATE LICENSE
ID
Enumeration date
02/07/2018
Last updated
02/07/2018
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