Autumn B Deda

NPI #1154598027 in Coeur D Alene, Idaho

Provider Information

NPI Number: 1154598027
Entity Type: Individual
Name: Autumn B Deda
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Occupational Therapist
Enumeration Date: May 9, 2008
Last Updated: May 9, 2008

Practice Location

Address: 500 W AQUA AVE
City: Coeur D Alene
State: Idaho
ZIP Code: 83815-7764
Phone: (208) 762-1122

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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