Individual
ALYCEA NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 11TH AVE S STE 155, NAMPA, ID 83651-3918
(208) 466-1077
Mailing address
5039 N BLUE ASH AVE, BOISE, ID 83713-2053
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
05/04/2021
Last updated
05/04/2021
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