Individual
CRYSTAL HELDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA, CMT
Contact information
Practice address
12604 N 14TH AVE, BOISE, ID 83714-5060
(208) 908-1322
Mailing address
12604 N 14TH AVE, BOISE, ID 83714-5060
(208) 908-1322
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA1109
ID
225700000X
Massage Therapist
M-09-020
ID
Other
Enumeration date
02/04/2010
Last updated
01/22/2015
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