MR. Kevin Jon Penner, CCC-SLP
NPI #1982377073 in Dalton Gardens, Idaho
Provider Information
- NPI Number
- 1982377073
- Entity Type
- Individual
- Name
- MR. Kevin Jon Penner, CCC-SLP
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Speech-Language Pathologist
- Credential
- CCC-SLP
- Enumeration Date
- Jul 26, 2021
- Last Updated
- Jul 26, 2021
Practice Location
- Address
- 6270 N GOVERNMENT WAY
- City
- Dalton Gardens
- State
- Idaho
- ZIP Code
- 83815-9214
- Phone
- (208) 666-0611
Specialties & Taxonomy Codes
| Specialty |
|---|
| Speech-Language Pathologist |
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