Individual
IVONNE MARIE MALDONADO DE LA ROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2550 S SAN TAN VILLAGE PKWY APT 2094, GILBERT, AZ 85295-7879
(787) 671-5275
Mailing address
2550 S SAN TAN VILLAGE PKWY APT 2094, GILBERT, AZ 85295-7879
(787) 671-5275
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
13103
AZ
235Z00000X
Speech-Language Pathologist
30762
CA
235Z00000X
Speech-Language Pathologist
4214
PR
235Z00000X
Speech-Language Pathologist
SLP011047
GA
Other
Enumeration date
05/01/2020
Last updated
10/26/2021
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