Individual
JESSICA BRODIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
165 FRONT STREET, DRIGGS, ID 83442
(307) 349-5377
Mailing address
165 FRONT STREET, DRIGGS, ID 83442
(307) 349-5377
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-2012
ID
Other
Enumeration date
03/08/2011
Last updated
03/08/2011
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