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General NPI Number Information
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NPI Number | 1598523086
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Entity Type | Organization
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Legal Business Name | SPEECH AND FEEDING NEST
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Dates
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Enumeration Date | 03/08/2024
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Last Update Date | 03/08/2024
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Provider Practice Location Address
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Address Line | 1940 W 4TH N
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City | SAINT JOHNS
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State | AZ
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Zip | 85936-4885
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Country | US
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Telephone | 480-707-1082
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2576
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City | SAINT JOHNS
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State | AZ
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Zip | 85936-2576
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Country | US
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Telephone | 480-707-1082
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | TIFANI KAYE WILHELM
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Credential |
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Telephone | 480-707-1082
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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 |
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License Number State |
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