Bonnie Marie Idso, MSCCCSLP | |
490 S Lassen St, Spc #3, Susanville, CA 96130-4893 | |
(510) 409-2032 | |
Not Available |
Full Name | Bonnie Marie Idso |
---|---|
Gender | Female |
Speciality | Speech-language Pathologist |
Location | 490 S Lassen St, Susanville, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1508183245 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | 22004774A (Indiana) | Secondary |
235Z00000X | Speech-language Pathologist | SP 10561 (California) | Primary |
Mailing Address | Practice Location Address |
---|---|
Bonnie Marie Idso, MSCCCSLP 490 S Lassen St, Spc #3, Susanville, CA 96130-4893 Ph: (510) 409-2032 | Bonnie Marie Idso, MSCCCSLP 490 S Lassen St, Spc #3, Susanville, CA 96130-4893 Ph: (510) 409-2032 |
Casey Wootan, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2005 River St, Susanville, CA 96130 Phone: 530-257-5341 | |
Carol Jane Forbes, SPPA Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1101 Modoc St, Susanville, CA 96130 Phone: 530-251-5775 Fax: 530-251-5775 |