Individual
ALEXA GRACE BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16428 E KINGSTREE BLVD, FOUNTAIN HILLS, AZ 85268-5440
(480) 837-4565
Mailing address
4501 E JOAN DE ARC AVE, PHOENIX, AZ 85032-6462
(602) 579-4691
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP10697
AZ
Other
Enumeration date
07/01/2017
Last updated
07/01/2017
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