Individual
KELSEY BRYN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
190 N 3950 E, RIGBY, ID 83442-5744
(208) 316-6713
Mailing address
190 N 3950 E, RIGBY, ID 83442-5744
(208) 316-6713
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-2827
ID
Other
Enumeration date
08/23/2016
Last updated
08/23/2016
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