Individual
MRS. MISTY RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
1460 ELK CREEK DR, IDAHO FALLS, ID 83404-8237
(208) 535-1286
Mailing address
4230 WANDA ST, AMMON, ID 83406-6875
(208) 520-8488
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
SLP-2177
ID
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
08/14/2010
Last updated
05/09/2025
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