Individual
LUZMARIA ACEVEDO-BANUELOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLPA
Contact information
Practice address
20329 N 59TH AVE STE A2, GLENDALE, AZ 85308-6854
(623) 500-2401
Mailing address
6239 W WINDSOR BLVD, GLENDALE, AZ 85301-7306
(623) 206-1541
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA11069
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLPA11069
ARIZONA DEPARTMENT OF HEALTH SERVICES
AZ
Enumeration date
05/31/2018
Last updated
05/31/2018
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