Individual
ALEECE BAN-JO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
320 11TH AVE S, NAMPA, ID 83651-5073
(208) 466-1077
Mailing address
320 11TH AVE S, NAMPA, ID 83651-5073
(208) 466-1077
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
262490157
ID
Other
Enumeration date
08/01/2017
Last updated
07/21/2022
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