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Individual

LINDA DIANE SHADLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4510 N 37TH AVE, PHOENIX, AZ 85019-3206
(602) 336-2931
Mailing address
4510 N 37TH AVE, PHOENIX, AZ 85019-3206
(602) 336-2931

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLPL5699
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
557986
ALHAMBRA SCHOOL DISTRICT#
AZ
Enumeration date
11/05/2007
Last updated
11/05/2007
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