Individual
MRS. SHAUNA MICHELLE GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10810 N TATUM BLVD, SUITE 102-185, PHOENIX, AZ 85028-6055
(602) 326-2619
(602) 297-6727
Mailing address
1031 E WESTCHESTER DR, TEMPE, AZ 85283-3038
(480) 862-9420
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
NONE
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLPA6317
DEPT OF HEALTH SERVICES LICENSE
AZ
Enumeration date
03/06/2007
Last updated
01/11/2010
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