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Individual

KRISTINA MICHELE ELLIOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, CCC-SLP

Contact information

Practice address
859 S YELLOWSTONE HWY STE 1701, REXBURG, ID 83440-5293
(208) 356-7643
Mailing address
133 N 3736 E, RIGBY, ID 83442-4935
(408) 250-1085

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-3529
ID

Other

Enumeration date
08/22/2018
Last updated
08/22/2018
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