Individual
FERN CLEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
210 W LACROSSE AVE, COEUR D ALENE, ID 83814-2403
(208) 664-2185
Mailing address
717 N GARRY DR, LIBERTY LAKE, WA 99019-7509
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-702
ID
225X00000X
Occupational Therapist
OT00003919
WA
Other
Enumeration date
06/26/2007
Last updated
07/08/2007
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