Organization
REACH THE SUMMIT LANGUAGE AND LITERACY CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRSTEN LEWIS MS,CCC-SLP (SPEECH PATHOLOGIST)
(208) 793-1557
Entity
Organization
Contact information
Practice address
445 S FITNESS PL, EAGLE, ID 83616-6828
(208) 793-1557
(208) 473-7337
Mailing address
PO BOX 1772, EAGLE, ID 83616-9106
(208) 793-1557
(208) 473-7337
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407201312
—
ID
Enumeration date
02/07/2020
Last updated
02/07/2020
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