Individual
MRS. AUDREY LYN HASSANI
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
440 FAIRFIELD ST N, TWIN FALLS, ID 83301
(208) 734-1430
(208) 734-0588
Mailing address
440 FAIRFIELD ST N, TWIN FALLS, ID 83301
(208) 734-1430
(208) 734-0588
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01026589
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010007166
REGENCE BLUE SHIELD
—
01
—
SPC83
BLUE CROSS OF ID
ID
Enumeration date
03/03/2006
Last updated
07/08/2007
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