Healthcare Provider Details

I. General information

NPI: 1851446512
Provider Name (Legal Business Name): MS. CONNIE O. GREEFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 S IRONWOOD DR
APACHE JUNCTION AZ
85220-5002
US

IV. Provider business mailing address

441 S MAPLE UNIT 134
MESA AZ
85206-5720
US

V. Phone/Fax

Practice location:
  • Phone: 480-982-1110
  • Fax:
Mailing address:
  • Phone: 480-982-1110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP4707
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: