Individual
WILLIAM J MCILQUHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4502 N CENTRAL AVE, PHOENIX UNION HIGH SCHOOL DISTRICT, PHOENIX, AZ 85012-1817
(602) 764-8561
Mailing address
21538 N 65TH AVE, GLENDALE, AZ 85308-6410
(623) 362-1947
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP0435
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
801698
—
AZ
Enumeration date
03/07/2007
Last updated
07/09/2007
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