Individual
ELLEN WESTERDAAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
331 E PARK ST, WEISER, ID 83672-2053
(208) 549-2416
Mailing address
331 E PARK ST, WEISER, ID 83672-2053
(208) 549-2416
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-146
ID
Other
Enumeration date
06/27/2008
Last updated
06/27/2008
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