Individual
MRS. CARISA A GEARHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
7 N 600 W, BLACKFOOT, ID 83221-5533
(208) 684-9812
Mailing address
3175 GOLDFIELD DR, POCATELLO, ID 83201-2777
(208) 604-0287
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1608
ID
Other
Enumeration date
07/14/2007
Last updated
07/14/2007
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