Individual
HANNA KIRSTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 11TH AVE S # UNITE155, NAMPA, ID 83651-3918
(208) 466-1077
Mailing address
11922 W FAIRVIEW AVE APT E405, BOISE, ID 83713-7933
(307) 413-6409
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
WY
225XP0200X
Pediatric Occupational Therapist
Primary
—
ID
Other
Enumeration date
10/11/2018
Last updated
03/25/2022
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