Individual
ABIGAIL EMILY ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CF-SLP
Contact information
Practice address
7211 W FRANKLIN RD, BOISE, ID 83709-0926
(208) 375-4200
(208) 375-4201
Mailing address
7211 W FRANKLIN RD, BOISE, ID 83709-0926
(208) 375-4200
(208) 375-4201
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-18-69702
CA
235Z00000X
Speech-Language Pathologist
Primary
TSLP-5408
ID
Other
Enumeration date
11/08/2018
Last updated
08/23/2022
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