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General NPI Number Information
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NPI Number | 1013230739
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Entity Type | Organization
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Legal Business Name | ARIZONA PEDIATRIC AUTISM CONSULTANTS
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 03/09/2010
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Provider Practice Location Address
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Address Line | 430 W WARNER RD SUITE 110
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City | TEMPE
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State | AZ
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Zip | 85284-2965
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Country | US
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Telephone | 480-227-9474
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Fax |
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Provider Business Mailing Address
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Address Line | 430 W WARNER RD SUITE 110
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City | TEMPE
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State | AZ
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Zip | 85284-2965
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Country | US
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Telephone | 480-227-9474
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICOLETTE JUDGE
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Credential | M.S. CCC-SLP
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Telephone | 480-227-9474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | SLP4621
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License Number State | AZ
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