Individual
MS. STACI NEUSTADT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
1745 S ALMA SCHOOL RD STE 145, MESA, AZ 85210-3049
(480) 963-3634
Mailing address
2113 N 68TH PL, SCOTTSDALE, AZ 85257-2626
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP4713
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12012239
ASHA MEMBER NUMBER
AZ
01
—
SLP4713
STATE LICENCE
AZ
Enumeration date
03/29/2007
Last updated
06/11/2019
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