Individual
PEYTON HAGEN-SHAFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(402) 350-7346
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-2301
ID
Other
Enumeration date
12/23/2021
Last updated
12/23/2021
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