Mrs. Mary Ann Mendoza De Guzman
Occupational Therapist - Gerontology
1200 Hospital Way
Pocatello
, Idaho 83201-2708
Mrs. Mary Ann Mendoza De Guzman
Occupational Therapist - Gerontology
1200 Hospital Way
Pocatello
, Idaho 83201-2708
(208) 233-1679
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About
Features
Specialties
- Occupational Therapist - Gerontology
Languages spoken
- English
Location
First Address
- Mrs. Mary Ann Mendoza De Guzman
- 2535 Woodhill Way
- Pocatello, ID
- Zip : 83201-2613
- Phone : (208) 233-1679
Second Address
- Mrs. Mary Ann Mendoza De Guzman
- 1200 Hospital Way
- Pocatello, ID
- Zip : 83201-2708
- Phone : (208) 232-2570
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225XG0600X | Occupational Therapist - Gerontology | OT-906 | ID |
National Provider Identifier
| NPI | 1376842419 |
|---|---|
| Provider Name | Mrs. Mary Ann Mendoza De Guzman |
| First Address | Pocatello, ID 83201-2613 |
| Second Address | Pocatello, ID 83201-2708 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/03/2011 |
| Last Update Date | 15/03/2011 |
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.