Individual
LISA CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
952 E BASELINE RD, SUITE A106, MESA, AZ 85204-6627
(480) 926-6309
Mailing address
952 E BASELINE RD, SUITE A106, MESA, AZ 85204-6627
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP2126
AZ
Other
Enumeration date
04/23/2007
Last updated
07/08/2007
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