Individual
MARIKA RENSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2870 JUNIPER DR, LEWISTON, ID 83501-4720
(208) 746-2855
Mailing address
24060 GIFFORD REUBENS RD, CULDESAC, ID 83524-6127
(208) 816-0607
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-3128
ID
Other
Enumeration date
10/18/2017
Last updated
10/18/2017
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