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Individual

MICHALA LIN CARRILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1550 N CRESTMONT DR STE F, MERIDIAN, ID 83642-2177
(208) 996-0523
Mailing address
1550 N CRESTMONT DR STE F, MERIDIAN, ID 83642-2177

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
LL60870422
WA
235Z00000X
Speech-Language Pathologist
Primary
SLP-4424
ID

Other

Enumeration date
09/24/2018
Last updated
11/05/2025
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