Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OT00003557 | WA |
Y | 225XG0600X | Occupational Therapist - Gerontology | OT-1058 | ID |
NPI | 1649477704 |
---|---|
Provider Name | Mrs. Wendy L Meguess |
First Address | Boise, ID 83713-1416 |
Second Address | Meridian, ID 83642-5031 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2007 |
Last Update Date | 20/02/2017 |