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Individual

KERRY MACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., SLP

Contact information

Practice address
10049 E DYNAMITE BLVD STE 110, SCOTTSDALE, AZ 85262-3694
(480) 419-0848
Mailing address
1109 W NEWPORT BEACH DR, GILBERT, AZ 85233-6742
(480) 216-7433

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP7367
AZ

Other

Enumeration date
07/05/2012
Last updated
07/05/2012
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