Individual
MISS JENNIFER NICHOLE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
25615 N RANCH GATE RD, SCOTTSDALE, AZ 85255-2141
(480) 502-7726
Mailing address
7474 E EARLL DR UNIT 112, SCOTTSDALE, AZ 85251-7922
(614) 572-5311
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP11526
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLP11526
TEMPORARY LICENSE AS SPEECH LANGUAGE PATHOLOGIST
AZ
Enumeration date
10/19/2018
Last updated
10/19/2018
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