Individual
JULIE ANN CRANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1650 N HILTON ST, BOISE, ID 83706-1734
(406) 230-1971
Mailing address
1650 N HILTON ST, BOISE, ID 83706-1734
(406) 230-1971
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-2176
ID
235Z00000X
Speech-Language Pathologist
SLP-SP-LIC-3085
MT
Other
Enumeration date
09/24/2010
Last updated
11/01/2013
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