Individual
LAURYN BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2302 N 15TH AVE, PHOENIX, AZ 85007-1201
(623) 242-6908
Mailing address
7033 W MERCER LN, PEORIA, AZ 85345-6032
(815) 494-9094
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP11395
AZ
235Z00000X
Speech-Language Pathologist
TSLP11395
AZ
Other
Enumeration date
08/17/2018
Last updated
04/29/2022
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