Individual
KATIE CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1410 S BROADWAY AVE, BOISE, ID 83706-3706
(208) 949-3481
Mailing address
11890 W FIDDLER DR, BOISE, ID 83713-1730
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-1749
ID
Other
Enumeration date
03/22/2017
Last updated
03/22/2017
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