NPI age
19 years
Enumerated 2007-01-29
Across 1046 active speech-language pathologist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | SLP-1297 | STATE OF IDAHO |
| 01 (UT) | 2766684102 | STATE LICENSE |
| 01 | 01080693 | ASHA |
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
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