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Individual

MR. JESSE LEE MONROE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS

Contact information

Practice address
3302 W LOUISE DR, PHOENIX, AZ 85027-1688
(623) 645-4556
Mailing address
3302 W LOUISE DR, PHOENIX, AZ 85027-1688
(623) 645-4556

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP11403
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SLP11403
ARIZONA DEPARTMENT OF EDUCATION
AZ
Enumeration date
11/06/2018
Last updated
11/06/2018
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