Individual
LUPE PISANO DEANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLPA
Contact information
Practice address
7012 N 22ND ST, PHOENIX, AZ 85020-5604
(602) 625-3571
(602) 955-0245
Mailing address
7012 N 22ND ST, PHOENIX, AZ 85020-5604
(602) 625-3571
(602) 955-0245
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA7935
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
94-1687665
E.I.N.
AZ
Enumeration date
11/08/2012
Last updated
11/08/2012
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