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Individual

KIONA RAQUEL LYNN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7836 W MCLELLAN RD, GLENDALE, AZ 85303-3405
(602) 428-1617
Mailing address
2337 W GABY RD, PHOENIX, AZ 85041-2024

Taxonomy

Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA11608
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SLPA11608
SLPA LICENSE
AZ
Enumeration date
01/08/2019
Last updated
01/08/2019
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