| NPI | 1003122847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUPE SEGOVIA Mips Coordinator 623-932-7141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP4856) |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2010-08-30 |