Graduated: 2001
NPI: 1427009398
Practice Locations (2)
IDAHO STATE UNIVERSITY
650 MEMORIAL DR BLDG, 68 ISU SPEECH AND HEARING CLINIC
POCATELLO, ID 832098116
2082823495
IDAHO STATE UNIVERSITY
921 S 8TH AVE, STOP 8116
POCATELLO, ID 832090001
Source: CMS National Downloadable File, September 2026.