Kristen Russell
Occupational Therapy Assistant
3169 S Bown Way
Boise
, Idaho 83706-5400
Kristen Russell
Occupational Therapy Assistant
3169 S Bown Way
Boise
, Idaho 83706-5400
(208) 344-4752
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About
Features
Specialties
- Occupational Therapy Assistant
Languages spoken
- English
Location
First Address
- Kristen Russell
- 3169 S Bown Way
- Boise, ID
- Zip : 83706-5400
- Fax : (208) 344-4752
- Phone : (208) 433-9152
Second Address
- Kristen Russell
- 3169 S Bown Way
- Boise, ID
- Zip : 83706-5400
- Fax : (208) 344-4752
- Phone : (208) 433-9152
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 224Z00000X | Occupational Therapy Assistant | OTA-094 | ID |
National Provider Identifier
| NPI | 1013246669 |
|---|---|
| Provider Name | Kristen Russell |
| First Address | Boise, ID 83706-5400 |
| Second Address | Boise, ID 83706-5400 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/12/2009 |
| Last Update Date | 10/12/2009 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.