Individual
MRS. MARY BETH HACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.S. IN SPEECH
Contact information
Practice address
6218 S 7TH ST, PHOENIX, AZ 85042-4211
(602) 326-3061
Mailing address
4304 E CAMPBELL AVE, APT # 1070, PHOENIX, AZ 85018-3701
(602) 326-3061
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3849437
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982724480
—
AZ
Enumeration date
04/09/2007
Last updated
07/08/2007
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