Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Kristopher Dwayne Wallin, COTA/L

Individual provider Occupational Therapy Assistant · NPI 1205215274

Mr. Kristopher Dwayne Wallin, COTA/L is an Occupational Therapy Assistant in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2015.

Licensed in
ID
In the registry since
2015
What do these letters mean?
COTA/L — Certified Occupational Therapy Assistant, Licensed
An occupational therapy assistant who is both certified and state licensed.

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Practice location Address checks out

8211 W Ustick Rd
Boise, ID 83704-5756
Phone: (208) 375-3700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence OTA-1423 (ID)

Record details

NPI number1205215274
Entity typeIndividual (Type 1)
GenderMale
Credentials COTA/L
Sole proprietorNo
NPI enumeratedMay 24, 2015
Last updated in NPPESMay 24, 2015

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