Individual
MR. BRIAN CAVANAGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S. CCC-SLP
Contact information
Practice address
5607 N EDDY PL, BOISE, ID 83714-5607
(208) 871-1531
Mailing address
5607 N EDDY PL, BOISE, ID 83714-5607
(208) 871-1531
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1760
ID
Other
Enumeration date
02/24/2014
Last updated
02/24/2014
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