Organization
SOUTHWEST MOBILE MBS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NOELLE M NICOLAS SLP (SPEECH-LANGUAGE PATHOLOGIST)
(480) 375-0145
Entity
Organization
Contact information
Practice address
712 E MICHIGAN AVE, PHOENIX, AZ 85022-1194
(480) 375-0145
(602) 535-4702
Mailing address
712 E MICHIGAN AVE, PHOENIX, AZ 85022-1194
(480) 375-0145
(602) 535-4702
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP5512
AZ
261QR0208X
Mobile Radiology Clinic/Center
—
AZ
Other
Enumeration date
02/12/2014
Last updated
07/30/2014
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