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1619525631
LISA JENNIFER DE LOS SANTOS
PHOENIX, AZ
NPI
1619525631
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: AZ TSLP11941)
Enumeration Date
2019-09-03
Last Update Date
2019-09-03
Business Address
LISA JENNIFER DE LOS SANTOS
2302 N 15TH AVE
PHOENIX, AZ 85007-1201
Phone number: 623-242-6908
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Mailing Address
LISA JENNIFER DE LOS SANTOS
14557 W INDIAN SCHOOL RD STE 500
GOODYEAR, AZ 85395-9218
Phone number: 623-242-6908
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