Individual
AMANDA CHEYENNE ENRICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
30 E LITTLE AVE, DRIGGS, ID 83422-5138
(208) 709-2911
Mailing address
548 COBBLECREST RD, DRIGGS, ID 83422
(208) 709-2911
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-835
ID
225X00000X
Occupational Therapist
OTR719
WY
Other
Enumeration date
08/13/2007
Last updated
06/21/2024
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