Individual
EDNA A. BRAXTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
SPECIAL EDUCATION DEPARTMENT, CHINLE, AZ 86503-0587
(928) 674-9576
Mailing address
PO BOX 388, CHINLE, AZ 86503-0388
(928) 674-2909
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP1200
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
235Z00000X
—
AZ
Enumeration date
04/18/2007
Last updated
07/09/2007
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