Individual
SHELLEY INDILICATO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3745 E RAVENSWOOD DR, GILBERT, AZ 85298-9124
(480) 414-8263
Mailing address
3745 E RAVENSWOOD DR, GILBERT, AZ 85298-9124
(480) 414-8263
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP7058
AZ
Other
Enumeration date
02/17/2011
Last updated
02/17/2011
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