MIRANDA SULLIVAN

EAGLE, ID
NPI1124600697
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
Enumeration Date2021-04-24
Last Update Date2021-04-24
Business Address
MIRANDA SULLIVAN MS, CCC-SLP
449 S FITNESS PL
EAGLE, ID 83616-6828
Phone number: 208-957-6301
Mailing Address
MIRANDA SULLIVAN MS, CCC-SLP
2920 W JEFFERSON ST
BOISE, ID 83702-4614
Phone number: 208-249-4890
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