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1104347939
ALEXA GRACE BAUTISTA
FOUNTAIN HILLS, AZ
NPI
1104347939
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: AZ TSLP10697)
Enumeration Date
2017-07-01
Last Update Date
2017-07-01
Business Address
ALEXA GRACE BAUTISTA
16428 E KINGSTREE BLVD
FOUNTAIN HILLS, AZ 85268-5440
Phone number: 480-837-4565
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Mailing Address
ALEXA GRACE BAUTISTA
4501 E JOAN DE ARC AVE
PHOENIX, AZ 85032-6462
Phone number: 602-579-4691
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