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Organization

SOUTHWEST CENTER FOR COMMUNICATION DISORDERS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LISA CRUJIDO M.S. CCC-SLP (OWNER/ADMINISTRATOR)
(928) 777-0172
Entity
Organization

Contact information

Practice address
802 AINSWORTH DR, SUITE C, PRESCOTT, AZ 86301-1630
(928) 777-0172
(928) 777-0174
Mailing address
802 AINSWORTH DR, SUITE C, PRESCOTT, AZ 86301-1630
(928) 777-0172
(928) 777-0174

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-3469
AZ
235Z00000X
Speech-Language Pathologist
0732
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036593
AZ
Enumeration date
05/15/2006
Last updated
09/11/2025
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