Individual
SHAUNA KISICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
8500 E JACKRABBIT RD, SCOTTSDALE, AZ 85250-6730
(480) 484-5073
Mailing address
7561 E SWEETWATER AVE, SCOTTSDALE, AZ 85260-4706
(480) 484-5073
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP4751
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
235Z00000X
—
AZ
Enumeration date
08/22/2022
Last updated
08/22/2022
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