Individual
MR. THOMAS GOSS MILLER GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, CCC-SLP
Contact information
Practice address
101 S ALLUMBAUGH WAY, BOISE, ID 83709-5658
(208) 323-8888
Mailing address
4934 N MAIDSTONE PL, BOISE, ID 83713-1363
(208) 891-7184
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-4916
ID
Other
Enumeration date
08/20/2021
Last updated
08/20/2021
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