Individual
MRS. KIMBERLEE D. WASSINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 666-2950
Mailing address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 666-2950
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12102371
ASHA CARD NUMBER
—
01
—
SLP-1578
IDAHO STATE LICENSE
ID
Enumeration date
01/09/2007
Last updated
08/21/2012
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