| NPI | 1740604719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NOELLE M NICOLAS Speech Language Pathologist 480-375-0145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP5512) |
| Additional Taxonomies | 261QR0208X Clinic/Center, Radiology, Mobile |
| Enumeration Date | 2014-02-12 |
| Last Update Date | 2014-07-30 |