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Individual

TIA BURNS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MOTR/L, CHT

Contact information

Practice address
560 MEMORIAL DR STE B, POCATELLO, ID 83201-4073
(208) 478-0258
Mailing address
882 WINGATE DR, POCATELLO, ID 83201-5468
(208) 680-1838

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-939
ID

Other

Enumeration date
10/02/2009
Last updated
06/08/2015
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