Individual
SIERRA PANCHO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25555 W DURANGO ST, BUCKEYE, AZ 85326-9176
(623) 925-3400
Mailing address
949 S GOODYEAR BLVD E APT 107, GOODYEAR, AZ 85338-4945
(623) 213-4055
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA12080
AZ
Other
Enumeration date
12/06/2019
Last updated
12/06/2019
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