Individual
MIKAILA HORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
113 N ELM ST, CANBY, OR 97013-3519
(503) 263-8903
Mailing address
113 N ELM ST, CANBY, OR 97013-3519
(503) 263-8903
(503) 266-8632
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2371
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
324591
OT LICENSE
OR
Enumeration date
05/27/2014
Last updated
01/23/2020
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