Individual
MRS. LISA ANN TRIMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
20402 N 15TH AVE, PHOENIX, AZ 85027-3636
(623) 445-5000
Mailing address
7386 W PIUTE AVE, GLENDALE, AZ 85308-5637
(623) 561-8204
(623) 566-6308
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP1029
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
577869
AHCCS PROVIDER
AZ
Enumeration date
04/04/2007
Last updated
07/08/2007
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