Healthcare Provider Details

I. General information

NPI: 1598222713
Provider Name (Legal Business Name): SALMON SPEECH AND SWALLOWING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2019
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 SHOUP ST STE 1
SALMON ID
83467-4306
US

IV. Provider business mailing address

516 MAIN ST # 368
SALMON ID
83467-4219
US

V. Phone/Fax

Practice location:
  • Phone: 208-244-2547
  • Fax: 208-756-2354
Mailing address:
  • Phone: 208-244-2547
  • Fax: 208-561-8382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANNA SCHROEDER
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential: M.S., CCC-SLP
Phone: 208-244-2547