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Individual

MRS. LAURI W. FELTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, CCC-SLP

Contact information

Practice address
3814 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7591
(208) 529-3562
(208) 529-4064
Mailing address
347 I STREET, IDAHO FALLS, ID 83402
(208) 523-2684

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1531
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12074086
ASHA
ID
01
SLP-1531
IDAHO LICENSURE
ID
01
SP714
BLUE CROSS
ID
Enumeration date
12/11/2006
Last updated
07/08/2007
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