| NPI | 1699388017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY BRIANA ALLING Speech Language Pathologist 208-471-4069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2020-08-25 |