Individual
KIMBERLY DEGRAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
901 N CURTIS RD STE 204, BOISE, ID 83706-1340
(208) 367-8282
Mailing address
1409 E COUGAR CREEK DR, MERIDIAN, ID 83646-7809
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP-4912
ID
Other
Enumeration date
08/08/2018
Last updated
09/14/2021
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