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Individual

KARISSA DEANNE MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1110 CALL CREEK DR STE 7, POCATELLO, ID 83201-3072
(208) 410-7670
Mailing address
2510 WOODHILL WAY, POCATELLO, ID 83201-2635
(208) 410-7670

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1670
ID

Other

Enumeration date
08/14/2008
Last updated
08/14/2008
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