Individual
KATHLEEN MACMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1828 BRIDGEVIEW BLVD, TWIN FALLS, ID 83301-3051
(208) 736-3933
Mailing address
1828 BRIDGEVIEW BLVD, TWIN FALLS, ID 83301-3051
(208) 736-3933
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1279
ID
Other
Enumeration date
06/08/2007
Last updated
07/08/2007
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