Individual
MR. MICHAEL CORONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15116 N COTTON LN, SURPRISE, AZ 85388-9618
(623) 322-8250
Mailing address
15116 N COTTON LN, SURPRISE, AZ 85388-9618
(623) 322-8250
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA10429
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLPA10429
SPEECH LANGUAGE PATHOLOGIST ASSISTANT
AZ
Enumeration date
01/19/2017
Last updated
06/21/2024
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