Individual
ERIN DEGROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3111 CHANNING WAY, IDAHO FALLS, ID 83404-7534
(208) 529-0067
Mailing address
2270 STACE ST, IDAHO FALLS, ID 83401-5231
(208) 891-0360
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-1583
ID
Other
Enumeration date
06/21/2017
Last updated
03/17/2018
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