Provider Demographics
NPI:1861648230
Name:HUYLAR, JOANNE M (MS)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:M
Last Name:HUYLAR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:M
Other - Last Name:LARSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:PO BOX 190376
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83719-0376
Mailing Address - Country:US
Mailing Address - Phone:208-761-6341
Mailing Address - Fax:208-846-8966
Practice Address - Street 1:2488 E GREEN CANYON DR
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-9194
Practice Address - Country:US
Practice Address - Phone:208-761-6341
Practice Address - Fax:208-846-8966
Is Sole Proprietor?:No
Enumeration Date:2008-08-17
Last Update Date:2008-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDSLP-1103235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist