| NPI | 1104099589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALESIA J. HITCHCOCK Speech Language Pathologist 208-376-3591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: ID SLP-1320) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2008-04-08 |