Individual
MRS. STEPHANIE ROSE CENTERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1515 N. LAKE HAVASU AVE., STE #100, LAKE HAVASU CITY, AZ 86404
(928) 854-5439
(928) 854-5440
Mailing address
1515 N. LAKE HAVASU AVE, STE #100, LAKE HAVASU CITY, AZ 86404
(928) 854-5439
(928) 854-5440
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
SLPA10564
AZ
235Z00000X
Speech-Language Pathologist
Primary
SLP10564
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274297
—
AZ
Enumeration date
06/07/2017
Last updated
12/07/2023
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