Individual
MRS. JEANETTE A OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
909 RESERVE ST., BOISE, ID 83712
(208) 343-7717
(208) 336-4629
Mailing address
4560 SE INTERNATIONAL WAY, STE. 100, MILWAUKIE, OR 97222
(971) 206-5200
(971) 206-5203
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-1088
ID
Other
Enumeration date
03/29/2012
Last updated
03/29/2012
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