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Individual

MRS. DAGNE HANSON SPACKMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS

Contact information

Practice address
3136 E SCORPIO PL, CHANDLER, AZ 85249-9644
(602) 301-6030
Mailing address
140 S GILBERT ROAD, GILBERT PUBLIC SCHOOLS MEDICAID SBCP, GILBERT, AZ 85296
(602) 301-6030

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP0680
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
493700
AZ
Enumeration date
01/03/2007
Last updated
08/25/2014
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