| NPI | 1699332601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA SWANDER Owner/Provider 208-861-7824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2025-05-14 |