Individual
SONDRA J BISTLINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
45 NORTH 100 EAST, FREDONIA, AZ 86022-0843
(928) 606-3565
(928) 643-6554
Mailing address
PO BOX 843, 45 N. 100 E., FREDONIA, AZ 86022-0843
(928) 606-3565
(928) 643-6554
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
8562432-4102
UT
235Z00000X
Speech-Language Pathologist
Primary
SLP6667
AZ
235Z00000X
Speech-Language Pathologist
TSLP6667
AZ
Other
Enumeration date
10/28/2010
Last updated
04/22/2020
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