| NPI | 1285128546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA NICHOLE BERGSMA Speech Language Pathologist/Owner 208-514-5660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: ID SLP2264) |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2018-06-20 |