Individual
MISS ASHLEY NICOLE BURKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20165 N 67TH AVE STE 221A, GLENDALE, AZ 85308-7002
(602) 573-5842
Mailing address
20165 N 67TH AVE STE 221A, GLENDALE, AZ 85308-7002
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP10764
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLP10764
SPEECH THERAPY
AZ
Enumeration date
08/04/2017
Last updated
08/04/2017
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