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Individual

DR. LESLIE DIANE BAJUSCAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AU.D.

Contact information

Practice address
515 W BUCKEYE RD, SUITE 106, PHOENIX, AZ 85003-2647
(602) 258-0298
(602) 254-8401
Mailing address
9250 N 3RD ST, SUITE 4010, PHOENIX, AZ 85020-2437
(602) 633-6348
(602) 633-3841

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
9275
NC
231H00000X
Audiologist
Primary
DA4099
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
86-0783428
TAX-ID
AZ
Enumeration date
03/13/2007
Last updated
02/07/2013
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