Individual
KEANDRIA GENICE THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17775 N 114TH DR, SURPRISE, AZ 85378-6989
(601) 665-7343
Mailing address
17775 N 114TH DR, SURPRISE, AZ 85378-6989
(601) 665-7343
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA14745
AZ
Other
Enumeration date
04/24/2024
Last updated
04/24/2024
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