Individual
MRS. LAURA CONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5480 W CAMPBELL AVE, PHOENIX, AZ 85031-1115
(623) 691-5165
Mailing address
17463 N 63RD DR, GLENDALE, AZ 85308-3682
(602) 938-3857
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
784787
—
AZ
Enumeration date
01/17/2007
Last updated
07/09/2007
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