Individual
PROF. JANENE A WILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
IDAHO STATE UNIVERSITY 921 S 8TH AVE, STOP 8116, POCATELLO, ID 83209-0001
(208) 282-3827
(208) 282-4571
Mailing address
62 YALE ST, POCATELLO, ID 83201-3436
(208) 282-3827
(208) 282-4571
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
ID
Other
Enumeration date
12/01/2006
Last updated
07/08/2007
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