Individual
COLLEEN M. HART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MACCCSLP
Contact information
Practice address
1031 W INDIAN HILLS PL, PHOENIX, AZ 85023-6278
(602) 243-8600
Mailing address
1031 W INDIAN HILLS PL, PHOENIX, AZ 85023-6278
(602) 243-8600
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP0188
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
463315
AHCCCS
AZ
01
—
AZ0143390
BLUE CROSS/BLUE SHIELD ID
AZ
Enumeration date
06/14/2005
Last updated
07/08/2007
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