Individual
LISA ANN MCINTIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1025 N COUNTRY CLUB DR, MESA, AZ 85201-3307
(480) 472-0727
(480) 472-0705
Mailing address
825 W MEDINA AVE, MESA, AZ 85210-7144
(480) 472-4041
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP0134
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
580440
—
AZ
01
—
SLP0134
LICENSE NUMBER
AZ
Enumeration date
03/27/2007
Last updated
07/09/2007
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