Individual
ALISA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
3702 DIETZ DR, STEVENSVILLE, MT 59870-7136
(208) 697-2444
Mailing address
3702 DIETZ DR, STEVENSVILLE, MT 59870-7136
(208) 697-2444
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-SP-LIC-5050
MT
Other
Enumeration date
02/12/2018
Last updated
02/12/2018
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