Individual
MS. BRIANA NORA TYNE ACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-2032
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT-2032
IDAHO OCCUPATIONAL THERAPY LICENSE
ID
Enumeration date
02/13/2019
Last updated
02/13/2019
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