Individual
LISA MICHELLE FUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7575 E MAIN ST, SCOTTSDALE, AZ 85251-4522
(480) 484-6532
Mailing address
6901 E CHAUNCEY LN APT 3055, PHOENIX, AZ 85054-5138
(906) 396-8312
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP1651
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
978116
—
AZ
Enumeration date
08/10/2017
Last updated
08/10/2017
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