Individual
SALLY ANNE SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
1250 IDAHO ST, LEWISTON, ID 83501-1965
(208) 799-5219
Mailing address
319 S MONROE ST, MOSCOW, ID 83843-3335
(208) 596-7753
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00003802
WA
Other
Enumeration date
02/16/2013
Last updated
02/16/2013
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