Individual
MICHELLE C COPPESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 W BIZZTOWN LOOP, HAYDEN, ID 83835-5113
(208) 762-3502
Mailing address
1401 N BIZTOWN LOOP, HAYDEN, ID 83835-5113
(208) 762-3502
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP 1500
ID
Other
Enumeration date
08/07/2008
Last updated
08/07/2008
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