Individual
MRS. CARRIE M. SPEED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4510 N 37TH AVE, PHOENIX, AZ 85019-3206
(602) 336-2990
Mailing address
3022 W CAMPBELL AVE, PHOENIX, AZ 85017-4146
(602) 589-0110
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
576572
AHCCCS PROVIDER NUMBER
AZ
Enumeration date
02/08/2007
Last updated
07/08/2007
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