Individual
MRS. ERIKA MARIE FULFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, OTR/L
Contact information
Practice address
1618 N 21ST ST, BOISE, ID 83702-0729
(208) 867-7029
Mailing address
1618 N 21ST ST, BOISE, ID 83702-0729
(208) 867-7029
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT-490
ID
Other
Enumeration date
03/20/2010
Last updated
03/20/2010
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