Individual
STACI DOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
1322 E LE MARCHE AVE, PHOENIX, AZ 85022-3245
(602) 283-4121
(602) 283-4184
Mailing address
PO BOX 30759, PHOENIX, AZ 85046-0759
(480) 406-3453
(602) 283-4184
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
SLPA8760
AZ
235Z00000X
Speech-Language Pathologist
Primary
SLP8760
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLP8760
ARIZONA DEPARTMENT OF HEALTH SERVICES
AZ
Enumeration date
09/09/2015
Last updated
06/25/2024
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