Provider Demographics
NPI:1558975607
Name:ROSSMILLER, TARYN (IS)
Entity Type:Individual
Prefix:
First Name:TARYN
Middle Name:
Last Name:ROSSMILLER
Suffix:
Gender:F
Credentials:IS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21254 ANTRIM DR
Mailing Address - Street 2:
Mailing Address - City:GREENLEAF
Mailing Address - State:ID
Mailing Address - Zip Code:83626-9130
Mailing Address - Country:US
Mailing Address - Phone:208-760-0989
Mailing Address - Fax:
Practice Address - Street 1:21254 ANTRIM DR
Practice Address - Street 2:
Practice Address - City:GREENLEAF
Practice Address - State:ID
Practice Address - Zip Code:83626-9130
Practice Address - Country:US
Practice Address - Phone:208-704-2575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-05
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist