| NPI | 1992309496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE LEIGH WALLIN Speech Language Pathologist 208-298-6183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2020-11-24 |
| Last Update Date | 2021-05-19 |