Healthcare Provider Details

I. General information

NPI: 1245147941
Provider Name (Legal Business Name): THE NEUROHIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4447 E 300 N
RIGBY ID
83442-5512
US

IV. Provider business mailing address

4447 E 300 N
RIGBY ID
83442-5512
US

V. Phone/Fax

Practice location:
  • Phone: 208-339-5283
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XH1300X
TaxonomyHuman Factors Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: KATIE WILLIAMS
Title or Position: OWNER/PRESIDENT
Credential: OT/L
Phone: 208-339-5283