Individual
JANE SUTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
2337 FIR DR, LAKESIDE, AZ 85929-5586
(928) 338-4842
Mailing address
PO BOX 2888, PINETOP, AZ 85935-2888
(928) 338-4842
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
DA1552
AZ
235Z00000X
Speech-Language Pathologist
SLPL4984
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
184935
AHCCCS
AZ
01
—
927395
AHCCCS
AZ
Enumeration date
04/03/2007
Last updated
02/12/2008
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