Individual
MATTIE BROKAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 E 10TH ST, TUCSON, AZ 85719-5813
(317) 695-2610
Mailing address
3750 E VIA PALOMITA APT 30204, TUCSON, AZ 85718-3363
(317) 695-2610
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP10066
AZ
Other
Enumeration date
12/02/2016
Last updated
12/02/2016
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