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General NPI Number Information
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NPI Number | 1093517435
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Entity Type | Individual
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Provider Name | KRYSTAL L SCHIESS M.S. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 1295 ALPINE AVE
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City | CHUBBUCK
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State | ID
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Zip | 83202-3100
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Country | US
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Telephone | 208-232-1447
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Fax |
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Provider Business Mailing Address
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Address Line | 4852 COLE ST
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City | CHUBBUCK
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State | ID
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Zip | 83202-2931
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Country | US
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Telephone | 208-705-2231
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | TSLP-5979
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License Number State | ID
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