Individual
KATRINA H BATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
859 S YELLOWSTONE HWY STE 1702, REXBURG, ID 83440-5412
(208) 356-7643
(208) 356-7708
Mailing address
4061 E 159 N, RIGBY, ID 83442-3002
(208) 360-2559
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-3839
ID
Other
Enumeration date
08/05/2024
Last updated
08/05/2024
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