Individual
JESSICA HARSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
6855 W FAIRVIEW AVE, BOISE, ID 83704-8046
(208) 323-8888
(208) 323-8889
Mailing address
6855 W FAIRVIEW AVE, BOISE, ID 83704-8046
(208) 323-8888
(208) 323-8889
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP-2072
ID
Other
Enumeration date
01/18/2011
Last updated
01/18/2011
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