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Individual

BRANDY LYNN GILEA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS-SLP

Contact information

Practice address
4650 HAWTHORNE RD STE 3B, CHUBBUCK, ID 83202-2376
(208) 237-9833
(208) 237-1800
Mailing address
415 MINDY DR, CHUBBUCK, ID 83202-2263
(208) 637-1003
(208) 237-1800

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1302
ID

Other

Enumeration date
03/24/2011
Last updated
03/24/2011
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