Organization
SPOTSAZ
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS ALEXANDER LABADIE (MANAGING PARTNER)
(480) 202-0781
Entity
Organization
Contact information
Practice address
558 S VALENCIA, MESA, AZ 85202-1719
(480) 202-0781
Mailing address
PO BOX 40783, MESA, AZ 85274-0783
(480) 202-0781
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLPL5719
AZ
Other
Enumeration date
08/10/2011
Last updated
08/10/2011
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