Individual
MRS. ELAINE CAMILLERI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSC CCC SLP
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP 2829
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
235700000X
TAXONOMY CODE
ID
Enumeration date
02/11/2016
Last updated
02/11/2016
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