Jacob Daniel Waller
Jacob Daniel Waller is a Speech/Language/Hearing Specialist/Technologist in Moscow, Idaho. Registered with an NPI since 2023.
- In the registry since
- 2023
- Specialties on file
- 2
Practice location Address checks out
875 Perimeter DrMoscow, ID 83844-9803
Phone: (208) 885-6111
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Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X |
|---|---|
| Speech/Language/Hearing Specialist/Technologist | Taxonomy 235500000X |
Record details
| NPI number | 1295428191 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | May 29, 2023 |
| Last updated in NPPES | May 29, 2023 |
| Certification date | May 28, 2023 |
| Mailing address | 11645 W Cross Slope Way, Nampa, ID 83686-5674 |
Other providers in Moscow
-
Diego Maldonado Quezada
875 Perimeter Dr, Moscow, ID 83844-9803 · (208) 885-6111
-
Vanessa Nicole Padilla
875 Perimeter Dr, Moscow, ID 83844-9803 · (208) 885-6111
-
Issac Bishop Sanchez, BS
875 Perimeter Dr, Moscow, ID 83844-9803 · (208) 885-6111
-
Cynthia Soderberg
1036 Aponi Pl, Moscow, ID 83843-0936 · (208) 724-5733