Individual
LYDIA LONGORIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
8700 S KYRENE RD, TEMPE, AZ 85284-2108
(480) 783-1204
Mailing address
924 W WINDSONG DR, PHOENIX, AZ 85045-0728
(480) 309-3573
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP5474
AZ
Other
Enumeration date
08/05/2007
Last updated
08/05/2007
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