Individual
LILLI HOMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
200 S REGINA RD, BOISE, ID 83716-3470
(208) 841-5462
Mailing address
200 S REGINA RD, BOISE, ID 83716-3470
(208) 841-5462
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1970
ID
Other
Enumeration date
12/09/2009
Last updated
01/27/2020
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