Individual
MS. DESIRAE MARIE LAPORTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2419 E MASSACHUSETTS AVE, NAMPA, ID 83686-6295
(916) 749-8260
Mailing address
3086 W MILANO DRIVE, MERIDIAN, ID 83646
(208) 996-0552
(208) 914-6597
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT-2169
ID
225XP0200X
Pediatric Occupational Therapist
Primary
OT-2169
ID
Other
Enumeration date
06/10/2021
Last updated
09/29/2023
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