Individual
MRS. LISA RAE MCBRIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
3446 MERLIN, IDAHO FALLS, ID 83404
(208) 523-3662
(208) 523-6002
Mailing address
3322 SANDY DR, IDAHO FALLS, ID 83401
(208) 604-1962
(208) 523-6002
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1415
ID
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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