Organization
VIRTUAL THERAPY ROOM, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON MICHELLE WATKINS MS, CCC-SLP (OWNER)
(480) 659-0536
Entity
Organization
Contact information
Practice address
5656 E HARMONY AVE, MESA, AZ 85206-6762
(480) 659-0536
Mailing address
5656 E HARMONY AVE, MESA, AZ 85206-6762
(480) 659-0536
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
SLP4236
AZ
Other
Enumeration date
11/10/2008
Last updated
11/10/2008
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