Individual
CARLY RENEE RIOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7880 W GREENWAY RD, PEORIA, AZ 85381-3830
(623) 412-5075
Mailing address
1905 E REDFIELD RD, PHOENIX, AZ 85022-4545
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TSLP11476
—
AZ
Enumeration date
09/18/2018
Last updated
09/18/2018
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