Individual
KRISTINE SCANLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 N ROBBINS RD, BOISE, ID 83702-4565
(208) 489-4635
Mailing address
600 N ROBBINS RD, BOISE, ID 83702
(208) 489-4635
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-2413
ID
Other
Enumeration date
02/13/2014
Last updated
02/13/2014
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