Individual
KLARIN LEANN FAUSETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3128 CHERRY TREE CIR, LEWISTON, ID 83501-7040
(916) 599-9334
Mailing address
3128 CHERRY TREE CIR, LEWISTON, ID 83501-7040
(916) 599-9334
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC61369541
WA
Other
Enumeration date
12/04/2023
Last updated
12/04/2023
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