Individual
ALISSA MCMINN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
150 MAIN STREET, BOX 10, RIGBY, ID 83442-5526
(208) 745-7101
Mailing address
4445 E 400 N, RIGBY, ID 83442-5526
(208) 745-6044
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-2228
ID
Other
Enumeration date
09/09/2015
Last updated
09/09/2015
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