Idaho State University - Meridian

NPI #1083860415 in Meridian, Idaho

Provider Information

NPI Number
1083860415
Entity Type
Organization
Organization Name
Idaho State University - Meridian
Primary Specialty
Speech-Language Pathologist
Enumeration Date
Aug 18, 2008
Last Updated
Jun 15, 2010

Practice Location

Address
1311 E CENTRAL DR
State
Idaho
ZIP Code
83642-7991
Phone
(208) 373-1728

Authorized Official

Name
MS. JEANNE M JOHNSON, PHD, CCC SLP
Title
ASSOCIATE CHAIR
Phone
(208) 373-1728

Specialties & Taxonomy Codes

Specialty
Speech-Language Pathologist

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