Individual
MR. COLTON SHAYN BLAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, CCC-SLP
Contact information
Practice address
823 HARRISON ST, TWIN FALLS, ID 83301-3925
(800) 926-2588
Mailing address
823 HARRISON ST, TWIN FALLS, ID 83301-3925
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP4811
ID
Other
Enumeration date
07/25/2021
Last updated
07/25/2021
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