| NPI | 1952665796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY ROBLEDO Speech Pathologist, Sole Proprietor 480-390-8746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X (Licence: AZ SLP6212) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: AZ SLP6212) |
| 252Y00000X Early Intervention Provider Agency (Licence: AZ SLP6212) | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2012-06-26 |