Individual
MS. JUANITA TABAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
212 W HILLSIDE AVE, APT A, PRESCOTT, AZ 86301-7502
(928) 533-9128
Mailing address
212 W HILLSIDE AVE, APT A, PRESCOTT, AZ 86301-7502
(928) 533-9128
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP7983
AZ
Other
Enumeration date
09/07/2012
Last updated
09/07/2012
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