Individual
VANESSA BOWDEN-RUNGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2685 N EDDY DR, FLAGSTAFF, AZ 86001-1018
(928) 310-4309
Mailing address
2685 N EDDY DR, FLAGSTAFF, AZ 86001-1018
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP11036
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14342739
AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION
—
Enumeration date
05/08/2019
Last updated
08/18/2023
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