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NPI 1053895854

NPI 1053895854 : TAYLOR FROST SLP-A : MESA, AZ

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General NPI Number Information
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    NPI Number           |    1053895854
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    Entity Type          |    Individual 
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    Provider Name        |    TAYLOR FROST SLP-A
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/18/2018
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    Last Update Date     |    09/18/2018
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Provider Practice Location Address
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    Address Line         |    1038 N ROBIN LN 
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    City                 |    MESA
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    State                |    AZ
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    Zip                  |    85213-5455
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    Country              |    US
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    Telephone            |    602-695-3036
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1038 N ROBIN LN 
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    City                 |    MESA
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    State                |    AZ
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    Zip                  |    85213-5455
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    Country              |    US
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    Telephone            |    602-695-3036
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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        |    2355S0801X
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    Taxonomy Name        |    Speech-Language Assistant
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    License Number       |    SLPA11406
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    License Number State |    AZ
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