Individual
KATHIE CLAIRE MENDEZ-SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
890 N COLE RD, SUITE A, BOISE, ID 83704-8638
(208) 323-8888
(208) 323-8889
Mailing address
2714 ARLINGTON AVE, APT 201, CALDWELL, ID 83605-7123
(208) 890-4023
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1419
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10000554
ASHA
—
Enumeration date
12/27/2006
Last updated
07/08/2007
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