Provider Demographics
NPI:1669124012
Name:NEUFELD, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:NEUFELD
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 1:3905 W NEEL ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-2126
Mailing Address - Country:US
Mailing Address - Phone:208-631-8568
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:208-908-6116
Practice Address - Fax:208-908-0486
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDOT-2516225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist