Individual
PATRICIA ANN BEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
890 N COLE RD, SUITE A, BOISE, ID 83704-8638
(208) 323-8888
(208) 323-8889
Mailing address
12861 N TOWN RIDGE RD, BOISE, ID 83714-9437
(208) 229-0303
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1192
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010157676
REGENCE BLUESHIELD OF ID
ID
01
—
09126064
ASHA
—
01
—
SLP04
BLUE CROSS INSURANCE
ID
Enumeration date
12/27/2006
Last updated
07/08/2007
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