Healthcare Provider Details

I. General information

NPI: 1902115280
Provider Name (Legal Business Name): REBECCA K STRICKLER OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2010
Last Update Date: 10/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

179 SW 5TH AVE
MERIDIAN ID
83642-2995
US

IV. Provider business mailing address

901 N CURTIS RD STE 204
BOISE ID
83706-1340
US

V. Phone/Fax

Practice location:
  • Phone: 208-367-8282
  • Fax: 208-367-8288
Mailing address:
  • Phone: 208-367-3315
  • Fax: 208-367-2674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT915
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: