Individual
MR. JONATHAN SCOTT RICHESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
440 N MARK ST, SAINT DAVID, AZ 85630-0334
(520) 720-8606
Mailing address
PO BOX 334, SAINT DAVID, AZ 85630-0334
(520) 720-8606
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLPL4128
AZ
Other
Enumeration date
01/26/2007
Last updated
07/08/2007
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