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1023401825
KELLI SHAW
BOISE, ID
NPI
1023401825
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: ID TSLP-2657)
Enumeration Date
2015-03-18
Last Update Date
2015-03-18
Business Address
-- KELLI SHAW
3115 N SYCAMORE DR
BOISE, ID 83703-4129
Phone number: 208-401-6401
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Mailing Address
-- KELLI SHAW
613 N HILLVIEW DR
BOISE, ID 83712-8120
Phone number: 208-353-7776
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