Organization
HUCKLEBERRY THERAPY LLC
Active
Other names
Huckleberry Speech & Language Services
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH NICOLE DESIMONE MS, CCC-SLP (OWNER)
(208) 994-3757
Entity
Organization
Contact information
Practice address
6101 E HIGHWAY 54, STE A, ATHOL, ID 83801-6085
(208) 994-3757
(208) 352-3921
Mailing address
7425 E TELLUM AVE, ATHOL, ID 83801-9293
(509) 496-3317
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016962
—
ID
Enumeration date
08/13/2021
Last updated
08/13/2021
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