Individual
KATELYN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1701 DISCOVERY PL, NAMPA, ID 83686-7179
(208) 477-1789
Mailing address
697 N KEAGAN WAY, MERIDIAN, ID 83642-5513
(208) 691-5785
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-4303
ID
Other
Enumeration date
07/24/2019
Last updated
11/08/2021
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