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General NPI Number Information
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NPI Number | 1629383005
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Entity Type | Organization
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Legal Business Name | SPEECH AMERICA LEARNING ASSOCIATE, INC.
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Dates
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Enumeration Date | 08/10/2010
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Last Update Date | 08/10/2010
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Provider Practice Location Address
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Address Line | 6050 N INVERGORDON RD
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City | PARADISE VALLEY
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State | AZ
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Zip | 85253-5248
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Country | US
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Telephone | 480-375-5054
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Fax | 480-874-2928
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Provider Business Mailing Address
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Address Line | 21001 N TATUM BLVD STE 1630-126
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City | PHOENIX
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State | AZ
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Zip | 85050-4206
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Country | US
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Telephone | 480-375-5054
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Fax | 480-368-7956
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | MS. LISA JEAN PICCININNI
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Credential | M.A,
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Telephone | 480-375-5054
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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 | SLP6457
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License Number State | AZ
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