Doctor Name: | MRS. JAIMEE TYSON-MCOMIE |
NPI Number: | 1114316817 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | SLP-1926 |
Business Practice Address: | 13176 W Persimmon Ln Suite 120 Boise, ID - 837135063 |
Business Phone Number: | 2083763591 |
Business Fax Number: | 2083763594 |
Mailing Address: | 13176 W Persimmon Ln, Suite 120 BOISE |
State: | ID |
Postal Code: | 837135063 |
Phone Number: | 2083763591 |
Fax Number: | 2083763594 |
NPI Enumeration Date: | 01/19/2015 |
NPI Last Update Date: | 01/19/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP-1926 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |