1740436302

Everything you always wanted to know about MILLER DEANNE KARISSA but were afraid to ask.

MILLER DEANNE KARISSA

You can also download the this 1740436302 data report as csv | excel | json | xml
Provider Last Name Provider Middle Name Provider First Name
MILLER DEANNE KARISSA
Gender:
Female
Enumeration date:
2008-08-14
Last update date:
2008-08-14
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
No
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Identifiers

identifier description issuer state

Taxonomies

Taxonomy State License Number Primary?
235Z00000X Speech-Language Pathologist ID SLP-1670 Y

Phone Numbers

Type Number
Mailing Address Telephone Number 2084107670
Practice Location Address Telephone Number 2084107670

Addresses

Type Address City State Postal Country
Mailing Address 2510 WOODHILL WAY POCATELLO ID 83201 ID
Practice Location Address 1110 CALL CREEK DR STE 7 POCATELLO ID 0 ID

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1922260686 BURRELL, TARA
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