Individual
MARY ANNE BAVARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
108 W UNIVERSITY DR, MESA, AZ 85201-5818
(619) 971-7067
Mailing address
3935 E ROUGH RIDER RD UNIT 1112, PHOENIX, AZ 85050-7354
(619) 971-7067
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP16215
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
241334
—
AZ
Enumeration date
06/03/2016
Last updated
06/29/2025
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