Provider Demographics
NPI:1225707821
Name:HOOB, HEATHER P (OTR/L)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:P
Last Name:HOOB
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18708 N START POINT PL
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83714-1223
Mailing Address - Country:US
Mailing Address - Phone:208-807-1130
Mailing Address - Fax:208-908-0486
Practice Address - Street 1:5400 W FRANKLIN RD STE H
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-1078
Practice Address - Country:US
Practice Address - Phone:717-701-3049
Practice Address - Fax:208-908-0486
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-08
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDOT-2209225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist