Ketha Mead
Developmental Therapist in Moscow, ID. Individual provider (NPI-1).
NPI number1073973301
StatusActive
Last updated in NPPESFeb 29, 2016
Details
- NPI
- 1073973301
- Entity type
- Individual (NPI-1)
- Name
- Ketha Mead
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 29, 2016
- Last updated
- Feb 29, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 222Q00000X | Developmental Therapist | – | – | Yes |
Practice location
1350 Troy RdSuite 2
Moscow, ID 83843-3995
Phone 208-882-6912 · Fax 208-882-8575
Mailing address
1350 Troy RdSuite 2
Moscow, ID 83843-3995
Phone 208-882-6912 · Fax 208-882-8575
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