Provider Demographics
NPI:1831437839
Name:SALOIS, PATRICIA M (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:M
Last Name:SALOIS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:MARY
Other - Last Name:LAGACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:31745 N CARAVELLE RD
Mailing Address - Street 2:
Mailing Address - City:ATHOL
Mailing Address - State:ID
Mailing Address - Zip Code:83801-8842
Mailing Address - Country:US
Mailing Address - Phone:208-683-3238
Mailing Address - Fax:208-683-3238
Practice Address - Street 1:1564 WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:RATHDRUM
Practice Address - State:ID
Practice Address - Zip Code:83858
Practice Address - Country:US
Practice Address - Phone:208-687-0431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDSLP-2322235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist