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General NPI Number Information
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NPI Number | 1639593171
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Entity Type | Organization
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Legal Business Name | JANE SOLOMON , MS CCC-SLP PC
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Dates
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Enumeration Date | 02/04/2014
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Last Update Date | 02/04/2014
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Provider Practice Location Address
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Address Line | 7460 E BLACK ROCK RD
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-3473
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Country | US
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Telephone | 602-410-2172
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Fax |
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Provider Business Mailing Address
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Address Line | 7460 E BLACK ROCK RD
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-3473
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Country | US
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Telephone | 602-410-2172
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Fax |
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Authorized Official
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Title or Position | AGENCY OWNER/SPEECH PATHOLOGIST
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Name | MRS. JANE SOLOMON BERKOWITZ
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Credential | MS, CCC-SLP
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Telephone | 602-410-2172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | AZSLP4058
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License Number State | AZ
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