| Lullaby Waters Pllc | |
|
1410 S Broadway Ave, Boise, ID 83706-3706 | |
| (208) 949-3481 | |
| Not Available |
| Full Name | Lullaby Waters Pllc |
|---|---|
| Type | Facility |
| Speciality | Occupational Therapist |
| Location | 1410 S Broadway Ave, Boise, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114342755 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | OT-1014 (Idaho) | Primary |
| Provider Name | Nicole M Nickell |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760788384 PECOS PAC ID: 8426374760 Enrollment ID: I20150304002388 |
| Mailing Address | Practice Location Address |
|---|---|
| Lullaby Waters Pllc 179 E Old Saybrook Dr, Boise, ID 83706-4918 Ph: () - | Lullaby Waters Pllc 1410 S Broadway Ave, Boise, ID 83706-3706 Ph: (208) 949-3481 |
Murry Odonnell, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 190 E Bannock St, Boise, ID 83712 Phone: 208-381-7275 | |
Dr. Breannen Mcenany, OTD, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 101 S Allumbaugh Way, Boise, ID 83709 Phone: 208-323-8888 | |
Anna Leora Rosse, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 600 N Robbins Rd, Boise, ID 83702 Phone: 208-489-4444 | |
Mr. Julie H Orozco, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 500 W Fort St, Mail Code(117), Boise, ID 83702 Phone: 208-422-1000 Fax: 208-422-1241 | |
Macaile Hutt, MASTERS IN OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1172 W Franklin Rd, Boise, ID 83709 Phone: 208-375-4200 Fax: 208-375-4201 | |
Claire Marie Johnson, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 190 E Bannock St, Boise, ID 83712 Phone: 208-381-2222 | |
Eric S Burback, OT Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 901 N Curtis Rd Ste 304, Boise, ID 83706 Phone: 208-342-4263 Fax: 208-375-0597 |