MEDICARE: MISS ARIEL DANIELLE DEMORET M.S., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SLP9506	AZ

General Provider Information

NPI Number	:	1497130454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ARIEL DANIELLE DEMORET M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	2225 W SOUTHERN AVE
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85202-4716
Country	:	US
Telephone Number	:	623-888-3502
Fax Number	:	480-795-6161

Provider Business Practice Location Address
First Line	:	2225 W SOUTHERN AVE
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85202-4716
Country	:	US
Telephone Number	:	623-888-3502
Fax Number	:	480-795-6161

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2015
Last Update Date	:	11/07/2018

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Directions to “ MISS ARIEL DANIELLE DEMORET M.S., CCC-SLP” Practice Location

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