Individual
SUSAN CRULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6218 S 7TH ST, PHOENIX, AZ 85042-4211
(602) 243-4866
Mailing address
5712 N 20TH ST, PHOENIX, AZ 85016-2631
(602) 274-6797
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP0020
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
581365A
—
AZ
Enumeration date
04/09/2007
Last updated
07/09/2007
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