Individual
VANESSA CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 11TH AVE S STE 155, NAMPA, ID 83651-3946
(208) 466-1077
(208) 467-2201
Mailing address
101 11TH AVE S STE 155, NAMPA, ID 83651-3946
(208) 466-1077
(208) 467-2201
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
8971781
ID
Other
Enumeration date
12/02/2025
Last updated
12/02/2025
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