Individual
LAURA DOLEZAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC/SLP
Contact information
Practice address
859 S YELLOWSTONE HWY, SUITE 1702, REXBURG, ID 83440-5293
(208) 351-5791
Mailing address
PO BOX 1, CHESTER, ID 83421-0001
(208) 624-3794
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1443
ID
Other
Enumeration date
07/14/2014
Last updated
07/14/2014
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