Individual
KAITLYN MASSEY SHUEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3171 S BOWN WAY, BOISE, ID 83706-5665
(208) 433-9152
Mailing address
3171 S BOWN WAY, BOISE, ID 83706-5665
(208) 433-9152
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-1063
ID
Other
Enumeration date
06/12/2015
Last updated
06/12/2015
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