Individual
MRS. MARY SHARYLE GAGNEPAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
8430 N 39TH AVE, PHOENIX, AZ 85051-4778
(602) 347-2235
(602) 347-2220
Mailing address
3109 N 46TH PL, PHOENIX, AZ 85018-6535
(602) 347-2235
(602) 347-2220
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
#SLPL0183
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
558992
—
AZ
Enumeration date
03/08/2007
Last updated
07/09/2007
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