Individual
MRS. BRENDA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10387 W. SHADOW ROCK DRIVE, BOISE, ID 83714
(208) 939-2208
Mailing address
10387 W. SHADOW ROCK DRIVE, BOISE, ID 83714
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1451
ID
Other
Enumeration date
01/25/2008
Last updated
01/25/2008
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