Individual
ANDREA N BONK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 342-2071
Mailing address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5404
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP7945
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
757032
—
AZ
Enumeration date
11/15/2012
Last updated
10/16/2020
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