Tallison Wilson, OTL

NPI 1447015524 · on the registry since 2024 · sole proprietor

Practice

Address: 10112 W Overland Rd
Boise, ID 83709
Phone: (208) 495-5401
Organisation at this address: Lifepath Supports Inc
Lifepath Services Llc
Lifepath Services Llc
Lifepath Services Llc
Skybreak Therapy, Pllc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 10

Registry record

Primary taxonomy: 225XP0200X
225XP0200X
Licence states on file: ID
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2024-02-16

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho