Organization
CLEAR TALK SPEECH THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EZEKIEL HANS KELSEY (SPEECH-LANGUAGE PATHOLOGIST)
(208) 320-5686
Entity
Organization
Contact information
Practice address
3231 SPRING CREEK DR, TWIN FALLS, ID 83301-8437
(208) 320-5686
Mailing address
3231 SPRING CREEK DR, TWIN FALLS, ID 83301-8437
(208) 320-5686
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1643
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861686032
—
ID
Enumeration date
11/04/2017
Last updated
11/04/2017
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