Laura Kathleen Willoughby M.S. CCC-SLP

NPI 1790183697 - Speech-Language Pathologist - 235Z00000X

NPI Details
NPI 1790183697
Gender Female
Enumeration Date 12/09/2014
Last Updated 12/09/2014
Entity Type Individual
Active Over 2 years ago
Practice Location
3882 S CAPULET AVE
MERIDIAN ID, 83642-5093, US
Phone (208) 863-7854
Fax
Business Location
3882 S CAPULET AVE
MERIDIAN ID, 83642-5093, US
Phone (208) 863-7854
Fax
Toxanomy
Taxonomy Code 235Z00000X
License State Idaho
License Number SLP-1408
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According to our database, Laura Kathleen Willoughby M.S. CCC-SLP NPI is 1790183697, taxonomy code is 235Z00000X and license number is SLP-1408, license state is located at Idaho. Laura Kathleen Willoughby M.S. CCC-SLP physically located at 3882 S Capulet Ave, Meridian ID, 83642-5093. NPI Number Laura Kathleen Willoughby M.S. CCC-SLP has the Individual type.

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1790183697 NPI number is provided on an as is basis without warranty of any kind. 1790183697 is maintained by the National Plan & Provider Enumeration System. The contents of Laura Kathleen Willoughby M.S. CCC-SLP are for informational purposes only.