Individual
JENESSA LYNN BAXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP-3375
Contact information
Practice address
14526 W COMISKY DR, BOISE, ID 83713-0966
(208) 880-1554
Mailing address
14526 W COMISKY DR, BOISE, ID 83713-0966
(208) 880-1554
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-3375
ID
Other
Enumeration date
12/14/2016
Last updated
06/13/2022
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