Individual
SUSAN MARY QUINN HURST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L, BCP
Contact information
Practice address
1001 PINE ST, SANDPOINT, ID 83864-1832
(208) 304-0652
Mailing address
PO BOX 2546, SANDPOINT, ID 83864-0917
(208) 263-6348
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1265
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201752356
TAX ID
AK
01
—
OT-816
OT LICENSE
ID
01
—
OT00000844
OT LICENSE
WA
05
—
OT4752
—
AK
Enumeration date
12/14/2006
Last updated
06/26/2008
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