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Individual

JESSICA EIDSVAAG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
3625 E RAY RD, #1136, PHOENIX, AZ 85044-7118
(480) 518-4682
Mailing address
198 E. CANARY CT., SAN TAN VALLEY, AZ 85143
(480) 518-4682

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP8769
AZ

Other

Enumeration date
02/26/2015
Last updated
06/10/2021
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