Organization
FUSION THERAPIES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY JENKINS MHS, CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(623) 256-1728
Entity
Organization
Contact information
Practice address
7747 W DEER VALLEY RD STE 255, PEORIA, AZ 85382-2124
(623) 256-1728
Mailing address
17333 W DURANGO ST, GOODYEAR, AZ 85338-1704
(623) 256-1728
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
—
252Y00000X
Early Intervention Provider Agency
Primary
SLP4344
AZ
Other
Enumeration date
12/15/2011
Last updated
12/15/2011
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