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General NPI Number Information
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NPI Number | 1538497615
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Entity Type | Individual
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Provider Name | HEATHER MHAIRI STEIMLOSK OTS, MSW
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Gender | Female
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Dates
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Enumeration Date | 11/30/2009
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Last Update Date | 08/15/2022
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Provider Practice Location Address
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Address Line | 3000 PANCHERI DR UNIT 3
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City | IDAHO FALLS
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State | ID
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Zip | 83402-5095
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Country | US
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Telephone | 208-523-5602
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Fax | 208-275-0787
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Provider Business Mailing Address
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Address Line | 1460 ELK CREEK DR
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City | IDAHO FALLS
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State | ID
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Zip | 83404-8237
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Country | US
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Telephone | 208-535-1286
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW 35130
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT-2561
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License Number State | ID
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