Individual
JILL SUZANNE PAINTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
1591 N MANSFIELD PL, EAGLE, ID 83616-6649
(408) 865-1365
Mailing address
1591 N MANSFIELD PL, EAGLE, ID 83616-6649
(408) 865-1365
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
10422
CA
225XP0200X
Pediatric Occupational Therapist
OT-2451
ID
Other
Enumeration date
10/23/2018
Last updated
06/20/2022
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