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1548044456
BETINA GYSSELLE TENNESSEN
MERIDIAN, ID
NPI
1548044456
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist
(Licence: TSLP-5934)
Enumeration Date
2023-08-22
Last Update Date
2023-08-22
Business Address
BETINA GYSSELLE TENNESSEN MS
3086 W MILANO DR
MERIDIAN, ID 83646-7288
Phone number: 208-996-0552
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Mailing Address
BETINA GYSSELLE TENNESSEN MS
3086 W MILANO DR
MERIDIAN, ID 83646-7288
Phone number:
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