Individual
MALLORY ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
302 2ND AVE E, TWIN FALLS, ID 83301-6425
(208) 749-3475
Mailing address
2662 JOSHUA WAY, TWIN FALLS, ID 83301-8953
(801) 663-9765
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-4224
ID
Other
Enumeration date
02/08/2020
Last updated
02/08/2020
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