Individual
MRS. KIM A HORACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4825 E ROOSEVELT ST, PHOENIX, AZ 85008-5917
(602) 629-6987
Mailing address
5408 S 55TH AVE, LAVEEN, AZ 85339-1527
(602) 629-6987
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLPL4337
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
855687
—
AZ
Enumeration date
02/21/2007
Last updated
07/08/2007
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