Individual
DR. DEBRA K VENKATESH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
2501 E SOUTHERN AVE, SUITE 21, TEMPE, AZ 85282-7669
(480) 833-4330
(480) 833-1902
Mailing address
2501 E SOUTHERN AVE, SUITE 21, TEMPE, AZ 85282-7669
(480) 833-4330
(480) 833-1902
Taxonomy
Speciality
Code
Description
License number
State
231HA2400X
Assistive Technology Practitioner Audiologist
Primary
DA1670
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0902100
BLUE CROSS BLUE SHIELD
AZ
01
—
470659
AHCCCS PROVIDER NUMBER
AZ
Enumeration date
10/14/2006
Last updated
07/08/2007
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