Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kimberly Wallis-Rucklos, MACCCSLP

Individual provider Speech-Language Pathologist · NPI 1548446420

Kimberly Wallis-Rucklos, MACCCSLP is a Speech-Language Pathologist in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2008.

Licensed in
ID
In the registry since
2008

Practice location Address checks out

6855 W Fairview Ave Ste 120
Boise, ID 83704-8502
Phone: (208) 323-8888
Fax: (208) 323-8889
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence SLP-1374 (ID)

Record details

NPI number1548446420
Entity typeIndividual (Type 1)
GenderFemale
Credentials MACCCSLP
Sole proprietorNo
NPI enumeratedJanuary 10, 2008
Last updated in NPPESJanuary 10, 2008

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