| NPI | 1992318273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA KNEZVICH Speech Language Pathologist 208-596-2779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0700X Clinic/Center, Hearing and Speech |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2020-08-26 |