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NPI Code Detail

MEDICARE: SARA JACOBSEN HULSIZER SLP

MEDICARE: SARA JACOBSEN HULSIZER SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSLP2859ID

General Provider Information

NPI Number : 1811323579
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA JACOBSEN HULSIZER SLP
Provider Business Mailing Address
First Line : 7211 W FRANKLIN RD
Second Line :
City : BOISE
State : ID
Zip : 83709-0926
Country : US
Telephone Number : 208-569-5433
Fax Number :
Provider Business Practice Location Address
First Line : 7211 W FRANKLIN RD
Second Line :
City : BOISE
State : ID
Zip : 83709-0926
Country : US
Telephone Number : 208-569-5433
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2013
Last Update Date : 03/13/2017

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Directions to “ SARA JACOBSEN HULSIZER SLP” Practice Location

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