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Individual

JEANINE ELIZABETH NESVIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
10631 S 51ST ST, SUITE 8, PHOENIX, AZ 85044-5225
(480) 398-4820
Mailing address
10631 S 51ST ST, SUITE 8, PHOENIX, AZ 85044-5225
(480) 398-4820

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP7490
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12139307
AMERICAN SPEECH AND HEARING ASSOCIATION
AZ
01
TSLP7490
ARIZONA DEPARTMENT OF HEALTH SERVICES
AZ
Enumeration date
08/29/2012
Last updated
08/29/2012
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