Individual
MRS. BETTY CHRISTINA JAQUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
7 N 600 W, BLACKFOOT, ID 83221-5533
(208) 684-9812
Mailing address
7 N 600 W, BLACKFOOT, ID 83221-5533
(208) 684-9812
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-232
ID
225XP0200X
Pediatric Occupational Therapist
OT-232
ID
Other
Enumeration date
01/03/2007
Last updated
09/11/2025
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