Individual
MS. NICOLE B. BUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CF-SLP
Contact information
Practice address
1515 N. LAKE HAVASU AVE, STE #100, LAKE HAVASU CITY, AZ 86404
(928) 854-5439
(928) 854-5440
Mailing address
1515 N. LAKE HAVASU AVE, STE #100, LAKE HAVASU CITY, AZ 86404
(928) 854-5439
(928) 854-5440
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP8446
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
832107
—
AZ
Enumeration date
07/15/2013
Last updated
03/01/2018
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