Individual
MRS. KRISTA BUZZELL RUDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
4650 HAWTHORNE RD, STE 3B, CHUBBUCK, ID 83202-2376
(208) 237-9833
Mailing address
2400 E TERRY ST, APT A, POCATELLO, ID 83201-2767
(208) 234-1274
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1486
ID
Other
Enumeration date
10/27/2010
Last updated
10/27/2010
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