Individual
PAIGE RACHELLE FRUIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22700 S POWER RD, QUEEN CREEK, AZ 85142-4507
(480) 424-8400
Mailing address
22659 E DESERT SPOON DR, QUEEN CREEK, AZ 85142-8545
(612) 554-6106
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP12498
AZ
235Z00000X
Speech-Language Pathologist
TSLP12498
AZ
Other
Enumeration date
07/08/2020
Last updated
09/08/2021
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