Individual
HOLLY NOELLE PACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
240 W BURNSIDE AVE STE D, CHUBBUCK, ID 83202-4703
(208) 904-1112
Mailing address
1053 W 110 S, BLACKFOOT, ID 83221-6057
(801) 425-5464
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT-2890
ID
Other
Enumeration date
01/15/2025
Last updated
01/15/2025
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