Individual
STACIE ELLIOTT-DONISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12643 N 34TH ST, PHOENIX, AZ 85032-7263
(602) 821-2171
Mailing address
12643 N 34TH ST, PHOENIX, AZ 85032-7263
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP4903
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144795
—
AZ
Enumeration date
10/24/2006
Last updated
08/27/2008
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