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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578775037 NPPES
Idaho MEDICAID 808172000

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