Individual
MRS. STACEY BONENBERGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22444 S 209TH WAY, QUEEN CREEK, AZ 85142-4877
(480) 433-0686
Mailing address
22444 S 209TH WAY, QUEEN CREEK, AZ 85142-4877
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
—
—
Other
Enumeration date
11/13/2017
Last updated
11/13/2017
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