Individual
MOLLY KATHLEEN MINTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
1460 ELK CREEK DR, IDAHO FALLS, ID 83404-8237
(208) 535-1286
Mailing address
4890 DAWSON RD, CORNING, CA 96021-9030
(530) 864-9361
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP21029
CA
Other
Enumeration date
05/19/2019
Last updated
05/19/2019
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