Doctor Name: | JAMIE JO GOICOECHEA |
NPI Number: | 1710232491 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | TSLP2265 |
Business Practice Address: | 2300 S Orchard St Suite B Boise, ID - 837056722 |
Business Phone Number: | 2089086469 |
Business Fax Number: | 2085776700 |
Mailing Address: | 2300 S Orchard St, Suite B BOISE |
State: | ID |
Postal Code: | 837056722 |
Phone Number: | 2089086469 |
Fax Number: | 2085776700 |
NPI Enumeration Date: | 07/18/2012 |
NPI Last Update Date: | 07/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | TSLP2265 |
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 |