| NPI | 1053185553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRY GRACE FARLEY Speech Language Pathologist 208-631-9813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2023-11-14 |
| Last Update Date | 2023-11-14 |