Ketha Mead

NPI #1073973301 in Moscow, Idaho

Provider Information

NPI Number: 1073973301
Entity Type: Individual
Name: Ketha Mead
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Developmental Therapist
Enumeration Date: Feb 29, 2016
Last Updated: Feb 29, 2016

Practice Location

Address: 1350 TROY RD
Address 2: SUITE 2
City: Moscow
State: Idaho
ZIP Code: 83843-3995
Phone: (208) 882-6912

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Developmental Therapist	222Q00000X	Primary

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