THERESE CHURCH-NYSTROM

PHOENIX, AZ
NPI1710422340
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist
(Licence: AZ  SLP10414)
Additional Taxonomies2355S0801X Specialist/Technologist Speech-Language Assistant
(Licence: AZ  10414)
Enumeration Date2017-01-06
Last Update Date2022-07-21
Business Address
THERESE CHURCH-NYSTROM
4545 N 36TH ST STE 125A
PHOENIX, AZ 85018-3456
Phone number: 602-224-0202
Mailing Address
THERESE CHURCH-NYSTROM
20250 N 67TH AVE APT 2162
GLENDALE, AZ 85308-6641
Phone number: 480-603-5115