Individual
KERRIE KRUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15002 N 32ND ST, PHOENIX, AZ 85032-4441
(602) 867-5223
(602) 867-5252
Mailing address
1952 E LUKE AVE, PHOENIX, AZ 85016-3014
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
DOH #SLP2171
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
843278
—
AZ
Enumeration date
10/18/2006
Last updated
07/09/2007
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