Jean, Janice
Jean, Janice is an sole proprietor health care provider with primary practice located at 560 Memorial Drive Suite B, Pocatello ID 83201-4621. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Jean, Janice can be contacted via phone (208) 478-0258.Contact Information
Primary practice address
560 Memorial Drive Suite B
Pocatello ID 83201-4621
Phone: (208) 478-0258
Fax: (208) 269-7336
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | OT-612 | Idaho |
Profile Details
| NPI number | 1578775037 |
|---|---|
| LBN Legal business name | Jean, Janice |
| Credentials | MOTR/L,CHT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 4th, 2007 |
| Last updated | Jan 7th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578775037 | NPPES |
| Idaho | MEDICAID | 808172000 |
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