Provider Demographics
NPI:1235888017
Name:TRANSFORMATION VOICE THERAPY
Entity Type:Organization
Organization Name:TRANSFORMATION VOICE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:K
Authorized Official - Last Name:NEGILSKI
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:208-850-5804
Mailing Address - Street 1:2125 W OVERLAND RD
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-3149
Mailing Address - Country:US
Mailing Address - Phone:208-850-5804
Mailing Address - Fax:208-321-4859
Practice Address - Street 1:2125 W OVERLAND RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-3149
Practice Address - Country:US
Practice Address - Phone:208-850-9054
Practice Address - Fax:208-332-1485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty