Individual
MISS BRENDA AUSBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2078
Mailing address
645 E HOLLY ST, APT 103, BOISE, ID 83712-7843
(616) 706-1256
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
1616
ID
Other
Enumeration date
09/13/2016
Last updated
09/13/2016
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