Individual
CLARESE N/A PYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1852 N PINGO AVE, KUNA, ID 83634-3368
(208) 407-1681
Mailing address
1852 N PINGO AVE, KUNA, ID 83634-3368
(208) 407-1681
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-1330
ID
Other
Enumeration date
05/23/2022
Last updated
05/23/2022
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