Individual
JESSICA SHOTWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
427 N 4TH AVE, POCATELLO, ID 83201-6341
(208) 271-6389
(208) 646-4415
Mailing address
209 S 14TH AVE, POCATELLO, ID 83201-4139
(208) 271-6389
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-5787
ID
Other
Enumeration date
04/03/2023
Last updated
01/04/2025
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