Individual
RHIANNA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOT
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-2492
Mailing address
7191 W TOBI CT, BOISE, ID 83714-6180
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-1805
ID
Other
Enumeration date
07/12/2020
Last updated
07/12/2020
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