Organization
PRESCOTT SPEECH & LANGUAGE SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. COLLEEN R POUQUETTE M.S., CCC-SLP (PRESIDENT)
(928) 445-1309
Entity
Organization
Contact information
Practice address
812 VALLEY ST, PRESCOTT, AZ 86305-1826
(928) 445-1309
(928) 445-0914
Mailing address
PO BOX 11312, PRESCOTT, AZ 86304-1312
(928) 445-1309
(928) 445-0914
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
OTC 4011
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
855091
AHCCCS
AZ
Enumeration date
01/29/2007
Last updated
12/05/2023
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