Individual
LAURA KATHLEEN WILLOUGHBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
3882 S CAPULET AVE, MERIDIAN, ID 83642-5093
(208) 863-7854
Mailing address
3882 S CAPULET AVE, MERIDIAN, ID 83642-5093
(208) 863-7854
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1408
ID
Other
Enumeration date
12/09/2014
Last updated
12/09/2014
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