Individual
MRS. BECKY JEAN GEWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC - SLP
Contact information
Practice address
2915 NORTH 4TH STREET, FLAGSTAFF, AZ 86004
(928) 779-1679
(928) 779-2822
Mailing address
2915 NORTH 4TH STREET, FLAGSTAFF, AZ 86004
(928) 779-1679
(928) 779-2822
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4541
AZ
235Z00000X
Speech-Language Pathologist
SLP4541
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
887010
AHCCCS #
AZ
05
—
887010
—
AZ
Enumeration date
10/12/2006
Last updated
07/01/2020
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