Wallin, Kristopher Dwayne
Wallin, Kristopher Dwayne is an individual health care provider with primary practice located at 8211 W Ustick Rd , Boise ID 83704-5756. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant, which is considered as his primary health care specialty. Wallin, Kristopher Dwayne can be contacted via phone (208) 375-3700.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant | 224Z00000X | OTA-1423 | Idaho |
Profile Details
| NPI number | 1205215274 |
|---|---|
| LBN Legal business name | Wallin, Kristopher Dwayne |
| Credentials | COTA/L |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 24th, 2015 |
| Last updated | May 24th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205215274 | NPPES |
| Other | 340040 | NATIONAL BOARD OF OCCUPATIONAL THERAPY |
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