Individual
MISS AUBRIE GANEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AZ SLP-A #13022
Contact information
Practice address
1252 S AVONDALE BLVD, AVONDALE, AZ 85323-8900
(623) 478-5700
Mailing address
1803 E DECATUR ST, MESA, AZ 85203-6658
(602) 616-8906
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
13022
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13022
SLP-A LICENSE
AZ
Enumeration date
09/15/2021
Last updated
09/15/2021
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