Provider Demographics
NPI:1811569098
Name:OHRT, DENISE
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:OHRT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3302 N FIREBALL CT
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-0168
Mailing Address - Country:US
Mailing Address - Phone:208-625-0541
Mailing Address - Fax:
Practice Address - Street 1:3302 N FIREBALL CT
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-0168
Practice Address - Country:US
Practice Address - Phone:208-625-0541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician