Individual
SUSAN E HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
820 ELM DR, ST MARIES, ID 83861-2119
(208) 245-4576
(208) 245-2138
Mailing address
141 SUSIE DR, ST MARIES, ID 83861-9527
(208) 582-3605
(208) 245-2138
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1946
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0026109
—
ID
Enumeration date
06/22/2010
Last updated
06/22/2010
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