AMANDA ELAINE TATE

IDAHO FALLS, ID
NPI1528683497
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: ID  TSLP-4302)
Enumeration Date2020-06-16
Last Update Date2020-06-16
Business Address
AMANDA ELAINE TATE
1460 ELK CREEK DR
IDAHO FALLS, ID 83404-8237
Phone number: 208-521-1622
Mailing Address
AMANDA ELAINE TATE
2566 MARS ST
IDAHO FALLS, ID 83402-2302
Phone number: 208-521-1622
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