Provider Demographics
NPI:1396944302
Name:SCHUETTE, JILL ANN (OTR/L)
Entity type:Individual
Prefix:MS
First Name:JILL
Middle Name:ANN
Last Name:SCHUETTE
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 1:4057 N LOWER RD
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83204-7112
Mailing Address - Country:US
Mailing Address - Phone:208-241-4906
Mailing Address - Fax:208-904-4473
Practice Address - Street 1:4057 N LOWER RD
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83204-7112
Practice Address - Country:US
Practice Address - Phone:208-241-4906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2018-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDOT-127225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation