Individual
KIRA FAZZARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2273 E GALA ST, MERIDIAN, ID 83642-7289
(208) 323-8888
Mailing address
101 S ALLUMBAUGH WAY, BOISE, ID 83709-5658
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-4654
ID
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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