Individual
MYSTI WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2127 W OVERLAND RD, BOISE, ID 83705-3149
(208) 321-4898
Mailing address
2888 N WOODY DR, BOISE, ID 83703-4863
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-2732
ID
Other
Enumeration date
06/16/2016
Last updated
06/16/2016
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