Individual
SHARON BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.,CCC-SLP0159
Contact information
Practice address
241 S 11TH AVE, SHOW LOW, AZ 85901-5711
(928) 205-8474
Mailing address
241 S. 11TH AVE., SHOW LOW, AZ 85901
(928) 205-8474
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP0159
AZ
Other
Enumeration date
11/18/2013
Last updated
11/18/2013
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