Individual
KIMBERLY A ENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
1351 WEST PINE AVE., MERIDIAN CARE AND REHABILITATION CENTER, MERIDIAN, ID 83642
(208) 888-7246
Mailing address
1351 WEST PINE AVE., MERIDIAN CARE AND REHABILITATION CENTER, MERIDIAN, ID 83642
(208) 888-7246
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1152
ID
Other
Enumeration date
12/06/2012
Last updated
12/06/2012
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