| NPI | 1558502526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACIE POLLARD Co Owner 208-237-8255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: ID SLP-1749) |
| Enumeration Date | 2009-03-20 |
| Last Update Date | 2009-03-20 |