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Individual

JUSTINE ALEECE CISNEROS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
25615 N RANCH GATE RD, SCOTTSDALE, AZ 85255-2141
(480) 221-7553
Mailing address
2050 E BISHOP DR, TEMPE, AZ 85282-2915
(480) 980-3914

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
#SLPA7568
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
#SLPA7568
SLPA/CERTIFICATION
AZ
Enumeration date
12/08/2011
Last updated
12/08/2011
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