Individual
ANDREA MARIE MOROGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., OTR/L
Contact information
Practice address
895 E STATE ST, EAGLE, ID 83616-6003
(208) 860-6229
(208) 287-9426
Mailing address
1940 S BONITO WAY STE 190, MERIDIAN, ID 83642-5618
(208) 287-9420
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
7776
MA
225XP0200X
Pediatric Occupational Therapist
Primary
OT-640
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8084437
—
ID
Enumeration date
05/03/2007
Last updated
03/01/2023
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