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Organization
IDAHO PEDIATRIC SPEECH AND LANGUAGE, LLC
Active
Organization
IDAHO PEDIATRIC SPEECH AND LANGUAGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATELYN SMITH CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(208) 691-5785
Entity
Organization
Contact information
Practice address
697 N KEAGAN WAY, MERIDIAN, ID 83642-5513
(208) 477-1789
Mailing address
697 N KEAGAN WAY, MERIDIAN, ID 83642-5513
(208) 691-5785
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
—
—
Other
Enumeration date
11/08/2021
Last updated
11/19/2021
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