Individual
KIRSTEN WALLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
979 E ENSOLORADO ST, KUNA, ID 83634-5179
(208) 412-7991
Mailing address
979 E ENSOLORADO ST, KUNA, ID 83634-5179
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-1282
ID
Other
Enumeration date
12/24/2013
Last updated
12/24/2013
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