Individual
BRENNA JENKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
320 11TH AVE S STE 204, NAMPA, ID 83651-5074
(208) 466-1077
Mailing address
910 NW 4TH ST, MERIDIAN, ID 83642-2102
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP-3274
ID
Other
Enumeration date
08/19/2017
Last updated
08/19/2017
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