| NPI | 1790200202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN HIBBS Owner 208-996-0552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: ID SLP-2299) |
| Additional Taxonomies | 225XP0200X Occupational Therapist Pediatrics |
| 2251P0200X Physical Therapist Pediatrics | |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2022-07-21 |