Individual
MR. TRACE JAHNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., CF-SLP
Contact information
Practice address
26934 N 178TH AVE, SURPRISE, AZ 85387-1075
(623) 980-4164
Mailing address
26934 N 178TH AVE, SURPRISE, AZ 85387-1075
(623) 980-4164
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP11455
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
841738
—
AZ
Enumeration date
09/05/2013
Last updated
11/05/2018
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