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Individual

MINDA B RAQUIPISO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MOT OTR/L

Contact information

Practice address
716 BOYER AVE, WALLA WALLA, WA 99362-2310
(509) 378-9920
Mailing address
716 BOYER AVE, WALLA WALLA, WA 99362
(509) 378-9920

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT 60205941
WA

Other

Enumeration date
02/18/2008
Last updated
01/06/2014
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