Individual
CASSIDY ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
240 W BURNSIDE AVE STE D, CHUBBUCK, ID 83202-4703
(208) 904-1112
Mailing address
1510 E FREMONT ST, POCATELLO, ID 83201-4127
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5671177
ID
Other
Enumeration date
01/12/2026
Last updated
04/12/2026
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