Individual
JUDY ANN CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
331 E PARK ST, WEISER, ID 83672-2053
(208) 549-2416
Mailing address
331 E PARK ST, WEISER, ID 83672-2053
(208) 549-2416
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
13567
OR
235Z00000X
Speech-Language Pathologist
Primary
SLP-1178
ID
Other
Enumeration date
09/30/2014
Last updated
09/30/2014
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