Individual
JEFFREY KENNETH DESPOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS CF-SLP
Contact information
Practice address
859 S YELLOWSTONE HWY, REXBURG, ID 83440-5293
(208) 356-7643
Mailing address
437 DUG OUT WAY, IDAHO FALLS, ID 83401-4266
(208) 569-2022
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP-5432
ID
Other
Enumeration date
08/09/2022
Last updated
08/09/2022
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