Individual
CAREN SHINAYO IMADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
331 E PARK ST, WEISER, ID 83672-2053
(208) 549-0206
Mailing address
331 E PARK ST, WEISER, ID 83672-2053
(208) 549-0206
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-157
ID
Other
Enumeration date
08/15/2018
Last updated
08/15/2018
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