Individual
CONSTANCE W NOVAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC SLP
Contact information
Practice address
1819 S DOBSON RD, STE 212, MESA, AZ 85202-5664
(480) 456-0719
Mailing address
1819 S DOBSON RD, STE 212, MESA, AZ 85202-5664
(480) 456-0719
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP0026
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
463951
—
AZ
Enumeration date
04/24/2007
Last updated
07/09/2007
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