Healthcare Provider Details
I. General information
NPI: 1720499320
Provider Name (Legal Business Name): CORTNEY HUFF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/16/2014
Last Update Date: 12/26/2024
Certification Date: 12/26/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2738 N IVY LN
POST FALLS ID
83854-5459
US
IV. Provider business mailing address
2738 N IVY LN
POST FALLS ID
83854-5459
US
V. Phone/Fax
- Phone: 360-839-1697
- Fax:
- Phone: 360-839-1697
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | 293267 |
| License Number State | OR |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | OT-2132 |
| License Number State | ID |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: