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Individual

MRS. COURTNEY WILEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
113 E AVENUE F, JEROME, ID 83338-3132
(208) 324-2443
Mailing address
474 S 100 W, JEROME, ID 83338-6089

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-2596
ID

Other

Enumeration date
06/30/2022
Last updated
06/30/2022
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