Individual
LUCILLE MAE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Mailing address
2401 S APPLE ST APT B202, BOISE, ID 83706-5182
(815) 201-4923
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2925
ID
Other
Enumeration date
02/23/2024
Last updated
02/23/2024
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