Doctor Name: | REBECCA RENEE FISH |
NPI Number: | 1336429653 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | TSLP-2124 |
Business Practice Address: | 15081 Widgeon Ave Caldwell, ID - 836078383 |
Business Phone Number: | 2088803080 |
Business Fax Number: | 2084549003 |
Mailing Address: | 15081 Widgeon Ave, CALDWELL |
State: | ID |
Postal Code: | 836078383 |
Phone Number: | 2088803080 |
Fax Number: | 2084549003 |
NPI Enumeration Date: | 08/17/2011 |
NPI Last Update Date: | 02/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | TSLP-2124 |
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 |