Individual
LISA JENNIFER DE LOS SANTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2302 N 15TH AVE, PHOENIX, AZ 85007-1201
(623) 242-6908
Mailing address
14557 W INDIAN SCHOOL RD STE 500, GOODYEAR, AZ 85395-9218
(623) 242-6908
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP11941
AZ
Other
Enumeration date
09/03/2019
Last updated
09/03/2019
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