Individual
MRS. THERESA CROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP-CCC
Contact information
Practice address
2200 IRONWOOD PL, COEUR D ALENE, ID 83814-2610
(208) 667-6486
Mailing address
8002 N SALMONBERRY LOOP, HAYDEN, ID 83835
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-2796
ID
Other
Enumeration date
08/11/2015
Last updated
08/11/2015
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