Organization
SL THERAPY SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BROOKE LYNN BUTLER MS CCC-SLP (OWNER)
(602) 680-3161
Entity
Organization
Contact information
Practice address
2824 BEAVERTAIL LANE, PINETOP, AZ 85935-7427
(602) 380-3161
Mailing address
2824 BEAVERTAIL LANE, PINETOP, AZ 85935-7427
(602) 380-3161
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20190826152611
AHCCCS PROVIDER APP IN PROCESS
AZ
Enumeration date
04/15/2021
Last updated
04/15/2021
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