Individual
CORNISA MARIE ABEYTA-GAXIOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3749 E 190 N, RIGBY, ID 83442-5623
(208) 252-4074
Mailing address
3749 E 190 N, RIGBY, ID 83442-5623
(208) 252-4074
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP 2098
ID
Other
Enumeration date
05/02/2014
Last updated
02/14/2024
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