Individual
JESSICA NATHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15802 N PARKVIEW PL, SURPRISE, AZ 85374-7466
(623) 876-7923
Mailing address
13345 W PORT ROYALE LN, SURPRISE, AZ 85379-6585
(602) 578-9217
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
SLPA10912
AZ
235Z00000X
Speech-Language Pathologist
Primary
TSLP10912
AZ
Other
Enumeration date
10/30/2017
Last updated
07/21/2020
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