Individual
AMY PENASKOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
16171 N BRINSON ST, NAMPA, ID 83687-5509
(208) 442-2525
Mailing address
18217 N HILLTOP RD, COLBERT, WA 99005-9131
(509) 828-3760
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
03/05/2021
Last updated
03/05/2021
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