Individual
MR. CONRAD WILLIAM ESTREM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A.CCC/SLP
Contact information
Practice address
2131 S BONITO WAY, MERIDIAN, ID 83642-1659
(208) 489-9500
Mailing address
2131 S BONITO WAY, MERIDIAN, ID 83642-1659
(208) 489-9500
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1365
ID
Other
Enumeration date
09/27/2012
Last updated
09/27/2012
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