Individual
TARA KRISTINE CLEMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
726 N THIRD AVE # UNTIB, SANDPOINT, ID 83864-1510
(760) 709-1125
Mailing address
726 N THIRD AVE # UNTIB, SANDPOINT, ID 83864-1510
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-1463
ID
Other
Enumeration date
10/31/2017
Last updated
10/31/2017
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