Individual
PATRICIA BACKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP-CCC
Contact information
Practice address
1190 E MISSOURI AVE STE 100, PHOENIX, AZ 85014-2719
(602) 393-0520
Mailing address
1190 E MISSOURI AVE STE 100, PHOENIX, AZ 85014-2719
(602) 393-0520
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP4497
AZ
Other
Enumeration date
10/23/2019
Last updated
10/23/2019
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