Individual
KIMBERLY TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10112 W OVERLAND RD, BOISE, ID 83709-1428
(208) 495-5401
(208) 445-3939
Mailing address
10112 W OVERLAND RD, BOISE, ID 83709-1428
(208) 495-5401
(208) 445-3939
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-2821
ID
Other
Enumeration date
05/30/2025
Last updated
05/30/2025
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