MEDICARE: CHRISTINE ELAINE DENARDO SLP-A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2355S0801X	Speech-Language Assistant	SLPA8659	AZ

General Provider Information

NPI Number	:	1154743623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE ELAINE DENARDO SLP-A

Provider Business Mailing Address
First Line	:	1526 W MISSOURI AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85015-2616
Country	:	US
Telephone Number	:	602-707-2600
Fax Number	:

Provider Business Practice Location Address
First Line	:	1526 W MISSOURI AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85015-2616
Country	:	US
Telephone Number	:	602-707-2600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2014
Last Update Date	:	01/17/2014

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Directions to “ CHRISTINE ELAINE DENARDO SLP-A” Practice Location

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