Individual
TIFFANY POLLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
316 E 1ST ST, MIDDLETON, ID 83644
(208) 654-6161
(208) 473-7320
Mailing address
11536 W PRISTINEBROOK DR, STAR, ID 83669-5784
(208) 654-6161
(208) 473-7320
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT-547
ID
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
OT-547
ID
225XP0200X
Pediatric Occupational Therapist
Primary
OT-547
ID
Other
Enumeration date
10/15/2014
Last updated
04/02/2021
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