BLAKE EDES

BOISE, ID
NPI1184194789
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: ID  SLP-4067)
Enumeration Date2018-11-27
Last Update Date2020-03-31
Business Address
BLAKE EDES
13075 W PERSIMMON LN STE 120
BOISE, ID 83713-1986
Phone number: 208-793-7006
Mailing Address
BLAKE EDES
4628 W PASADENA LN APT 101
BOISE, ID 83705-6527
Phone number: