Individual
SHANNON MARIE CARROTHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
520 S EAGLE RD, MERIDIAN, ID 83642-6351
(208) 706-5000
Mailing address
7578 W SAXTON DR APT 303, BOISE, ID 83714-5176
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-4776
ID
Other
Enumeration date
07/22/2022
Last updated
07/22/2022
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