Healthcare Provider Details

I. General information

NPI: 1508170028
Provider Name (Legal Business Name): KATHLEEN T DOMBROWSKI MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2010
Last Update Date: 07/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9870 E WINDROSE DR
SCOTTSDALE AZ
85260-4616
US

IV. Provider business mailing address

9870 E WINDROSE DR
SCOTTSDALE AZ
85260-4616
US

V. Phone/Fax

Practice location:
  • Phone: 602-430-4005
  • Fax: 480-860-2223
Mailing address:
  • Phone: 602-430-4005
  • Fax: 480-860-2223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA6781
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: