Provider Demographics
NPI:1467571075
Name:KIRCHGASLER, CLAUDIA ROBERTS (MA CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:CLAUDIA
Middle Name:ROBERTS
Last Name:KIRCHGASLER
Suffix:
Gender:F
Credentials:MA CCC SLP
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Mailing Address - Street 1:1820 E 17TH STREET
Mailing Address - Street 2:SUITE 270
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404
Mailing Address - Country:US
Mailing Address - Phone:208-524-3740
Mailing Address - Fax:208-524-3740
Practice Address - Street 1:1820 E 17TH STREET
Practice Address - Street 2:SUITE 270
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404
Practice Address - Country:US
Practice Address - Phone:208-524-3740
Practice Address - Fax:208-524-3740
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDSLP1139235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist