Individual
CHRISTINE ANN CONNOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18617 N 5TH AVE, PHOENIX, AZ 85027-5675
(602) 703-2499
Mailing address
18617 N 5TH AVE, PHOENIX, AZ 85027-5675
(602) 703-2499
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA7974
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLPA7974
SPEECH LANGUAGE PATHOLOGY ASSISTANT LICENSE
AZ
Enumeration date
08/28/2012
Last updated
08/28/2012
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