Individual
MRS. TAMRA DIMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L, CLT
Contact information
Practice address
840 ADDISON AVE, TWIN FALLS, ID 83301-5203
(208) 595-4941
(208) 595-4931
Mailing address
2620 JOSHUA WAY, TWIN FALLS, ID 83301-8953
(208) 539-1282
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-1643
ID
Other
Enumeration date
05/09/2018
Last updated
05/09/2018
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