Individual
KATHLEEN STANSBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4650 W SWEETWATER AVE, GLENDALE, AZ 85304-1505
(602) 347-2653
Mailing address
11651 N 22ND ST, PHOENIX, AZ 85028-1701
(602) 992-7120
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP1514
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
588270
—
AZ
Enumeration date
04/13/2007
Last updated
08/31/2009
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