Individual
NEELY NICOLE MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6635 W HAPPY VALLEY RD STE A104-218, GLENDALE, AZ 85310-2609
(602) 920-2686
Mailing address
1029 E LODGEPOLE DR, GILBERT, AZ 85298-7313
(480) 650-6069
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA14123
AZ
Other
Enumeration date
09/21/2022
Last updated
01/04/2023
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