Individual
VIRGINIA M. TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 HAVASUPAI BLVD, LAKE HAVASU CITY, AZ 86403-3122
(928) 505-6938
Mailing address
777 HARRAH WAY APT 334, LAKE HAVASU CITY, AZ 86403-0820
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP7392
AZ
Other
Enumeration date
09/12/2011
Last updated
09/12/2011
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