Organization
AGUA FRIA UNION HIGH SCHOOL DIST #216
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUPE SEGOVIA (MIPS COORDINATOR)
(623) 932-7141
Entity
Organization
Contact information
Practice address
1481 N ELISEO FELIX JR WAY, AVONDALE, AZ 85323-1216
(623) 932-7141
Mailing address
1481 N ELISEO FELIX JR WAY, AVONDALE, AZ 85323-1216
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP4856
AZ
Other
Enumeration date
08/30/2010
Last updated
08/30/2010
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