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Individual

KAREN RENE LOCKWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
331 E PARK ST, WEISER, ID 83672-2053
(208) 549-2416
Mailing address
2553 RUNWAY CT, PAYETTE, ID 83661-2089
(208) 642-0805

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-160
ID

Other

Enumeration date
06/30/2008
Last updated
06/30/2008
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