Individual
LEAANNA BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
1210 NW 16TH ST, FRUITLAND, ID 83619-2202
(208) 452-8700
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
31034
OR
231H00000X
Audiologist
AUD-5414
ID
Other
Enumeration date
05/25/2022
Last updated
08/23/2022
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