Individual
MRS. MARY ANN MENDOZA DE GUZMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1200 HOSPITAL WAY, POCATELLO, ID 83201-2708
(208) 232-2570
Mailing address
2535 WOODHILL WAY, POCATELLO, ID 83201-2613
(208) 233-1679
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
OT-906
ID
Other
Enumeration date
03/15/2011
Last updated
03/15/2011
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