Organization
NORTHWEST PEDIATRIC SPEECH THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEGAN MCMASTER-STINE CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(208) 660-9463
Entity
Organization
Contact information
Practice address
1130 W HAYDEN AVE STE 103, HAYDEN, ID 83835-8720
(208) 660-9463
(208) 908-0044
Mailing address
1130 W HAYDEN AVE STE 103, HAYDEN, ID 83835-8720
(208) 660-9463
(208) 908-0044
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740793405
—
ID
Enumeration date
06/19/2020
Last updated
06/30/2023
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