Individual
CAMILLE JANE WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1501 HILAND AVE, BURLEY, ID 83318-2688
(208) 677-6530
Mailing address
1501 HILAND AVE, BURLEY, ID 83318-2688
(208) 677-6530
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP-3199
ID
Other
Enumeration date
05/30/2017
Last updated
07/21/2022
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