| NPI | 1669734042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON LYNN DUNN Business Manager 208-883-3195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2012-06-12 |