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Individual

NIKKI LEIGH KERNS-BENTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1833 S MILLENNIUM WAY, SUITE 100, MERIDIAN, ID 83642-1510
(208) 898-1368
Mailing address
4281 S VARIAN AVE, BOISE, ID 83709-5896
(208) 631-7699

Taxonomy

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

Other

Enumeration date
06/10/2008
Last updated
06/10/2008
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