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General NPI Number Information
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NPI Number | 1043341803
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Entity Type | Individual
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Provider Name | PETER OROURKE M.S. CCC-SLP
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Gender | Male
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 05/12/2011
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Provider Practice Location Address
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Address Line | 20311 E STONECREST DR
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-6302
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Country | US
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Telephone | 805-341-2334
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Fax |
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Provider Business Mailing Address
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Address Line | 20311 E STONECREST DR
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-6302
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Country | US
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Telephone | 805-341-2334
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP4125
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License Number State | AZ
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