Individual
TANYA PERKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1351 W PINE AVE, MERIDIAN, ID 83642-5031
(208) 895-6431
Mailing address
1351 W PINE AVE, MERIDIAN, ID 83642-5031
(208) 895-6431
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-1122
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTA-1122
STATE OF IDAHO
ID
Enumeration date
11/20/2012
Last updated
11/20/2012
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