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Individual

MICHELLE ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
125 ARDEN DR, IDAHO FALLS, ID 83404-7902
(208) 716-0172
Mailing address
125 ARDEN DR, IDAHO FALLS, ID 83404-7902
(208) 716-0172

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1362
ID

Other

Enumeration date
12/02/2014
Last updated
12/02/2014
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