| NPI | 1811385297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA WILLOUGHBY Owner 208-863-7854 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: ID SLP-1408) |
| Enumeration Date | 2015-01-07 |
| Last Update Date | 2015-01-07 |