Individual
MS. LENORA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
16182 W. PICCADILLY ROAD, GOODYEAR, AZ 85395-8082
(623) 203-5348
(623) 505-5350
Mailing address
16182 W PICCADILLY RD, GOODYEAR, AZ 85395-8082
(623) 203-5348
(623) 505-5350
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP5574
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
245616
AHCCCS PROVIDER NUMBER
AZ
Enumeration date
08/01/2007
Last updated
12/09/2010
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