Individual
MRS. JANE C ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, SLP-CCC
Contact information
Practice address
2377 CORONADO ST, IDAHO FALLS, ID 83404-7440
(208) 535-1286
(208) 535-1291
Mailing address
1593 HALSEY ST, IDAHO FALLS, ID 83401-3068
(208) 757-8300
(208) 535-1291
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1744
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01916
—
ID
Enumeration date
01/26/2009
Last updated
07/15/2014
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