Organization
ELITE SPEECH PATHOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY ANN CONTRERAS M.S. CCC SLP (OWNER/CEO)
(480) 612-7362
Entity
Organization
Contact information
Practice address
1806 W PAMPA AVE, MESA, AZ 85202-8013
(480) 612-7362
(480) 393-3670
Mailing address
1806 W PAMPA AVE, MESA, AZ 85202-8013
(480) 612-7362
(480) 393-3670
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
SLP4118
AZ
252Y00000X
Early Intervention Provider Agency
SLP4118
AZ
Other
Enumeration date
09/20/2008
Last updated
09/20/2008
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