Individual
HEATHER MANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1220 MONTANA ST, GOODING, ID 83330-1856
(208) 934-5601
Mailing address
1220 MONTANA ST, GOODING, ID 83330-1856
(208) 934-5601
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-1605
ID
Other
Enumeration date
05/26/2016
Last updated
05/26/2016
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