Individual
KYLIE MICHELLE BULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1409 W MAIN ST STE 120, BOISE, ID 83702-5215
(208) 370-5857
(208) 506-6312
Mailing address
935 E WINDING CREEK DR STE 120, EAGLE, ID 83616-7242
(208) 938-4748
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP-3247
ID
Other
Enumeration date
07/24/2017
Last updated
05/17/2023
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