Individual
JESSICA MARIE BIGONEY POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
3211 W BELLOMY LN, BOISE, ID 83703-5311
(907) 299-8230
Mailing address
3211 W BELLOMY LN, BOISE, ID 83703-5311
(907) 299-8230
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-3061
ID
Other
Enumeration date
08/16/2012
Last updated
11/10/2021
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