Individual
BROOK ORCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1717 W NORTHERN AVE STE 117, PHOENIX, AZ 85021-5470
(602) 535-8255
(602) 535-8254
Mailing address
4957 S JOSHUA TREE LN, GILBERT, AZ 85298-0470
(651) 428-5388
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP8582
AZ
Other
Enumeration date
01/16/2017
Last updated
01/16/2017
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