Individual
JOLENE M WRIGHT BOSTOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP/L
Contact information
Practice address
560 SHOUP AVE W, TWIN FALLS, ID 83301-5029
(208) 737-2126
Mailing address
4351 N WELLSPRING AVE, BOISE, ID 83713-0857
(208) 939-6418
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1324
ID
Other
Enumeration date
12/03/2008
Last updated
12/03/2008
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