Individual
KELLY MANWARING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3315 8TH ST, LEWISTON, ID 83501-4966
(208) 743-9543
Mailing address
3315 8TH ST, LEWISTON, ID 83501-4966
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1882
ID
Other
Enumeration date
04/01/2017
Last updated
04/01/2017
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