Individual
CHARRONDA WILLOUGHBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9057 N 98TH AVE, PEORIA, AZ 85345-3730
(208) 971-9543
Mailing address
9057 N 98TH AVE, PEORIA, AZ 85345-3730
(208) 971-9543
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA-134941
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLPA-13491
ARIZONA DEPARTMENT OF HEALTH
AZ
Enumeration date
03/16/2022
Last updated
03/16/2022
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