Individual
NICOLE CLOVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
449 S FITNESS PL, EAGLE, ID 83616-6828
(208) 957-6301
Mailing address
2650 E BLACKSTONE DR, EAGLE, ID 83616-7302
(208) 869-5209
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-3877
—
Other
Enumeration date
09/14/2021
Last updated
09/14/2021
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