Individual
ERNESTINE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
1033 W QUINN RD, POCATELLO, ID 83202-2425
(208) 233-4800
(208) 233-4887
Mailing address
1033 W QUINN ROAD, POCATELLO, ID 83202-2425
(208) 233-4800
(208) 233-4887
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1789
ID
Other
Enumeration date
10/18/2012
Last updated
10/18/2012
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