| NPI | 1063614741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE HANSEN Speech Language Pathologist 520-721-4544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ 00135236) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: AZ 00000174) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2013-11-14 |