Individual
MS. VIRGINIA SHERYL PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. SLP-CCC
Contact information
Practice address
NAVAJO RT 12, WINDOW ROCK UNIFIED SCHOOL DISTRICT, FT DEFIANCE, AZ 86504
(928) 729-6757
(928) 524-6367
Mailing address
PO BOX 1817, FORT DEFIANCE, AZ 86504-1817
(928) 241-1141
(928) 524-6367
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP5025
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119272
—
AZ
Enumeration date
12/15/2006
Last updated
07/09/2007
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