Individual
LYNNE KAULBACK ORANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., CCC-SLP
Contact information
Practice address
11111 E ARROYO LN, ATHOL, ID 83801-7808
(650) 556-4225
Mailing address
PO BOX 982, ATHOL, ID 83801-0982
(650) 556-4225
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
16279
CA
235Z00000X
Speech-Language Pathologist
2202004958
VA
235Z00000X
Speech-Language Pathologist
Primary
4048
ID
Other
Enumeration date
07/08/2008
Last updated
04/26/2023
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