| NPI | 1821255175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY M POUND Speech Language Pathologist 208-420-2587 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: ID SLP-1243) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2008-05-22 |