MEDICARE: ARIZONA SPEECH ASSOCIATES

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	252Y00000X	Early Intervention Provider Agency	SLP1760	AZ

General Provider Information

NPI Number	:	1396985685
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIZONA SPEECH ASSOCIATES

Provider Business Mailing Address
First Line	:	2234 S TORREY PINES CIR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85710-7948
Country	:	US
Telephone Number	:	520-631-1978
Fax Number	:	520-615-9884

Provider Business Practice Location Address
First Line	:	2234 S TORREY PINES CIR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85710-7948
Country	:	US
Telephone Number	:	520-631-1978
Fax Number	:	520-615-9884

Authorized Official
Title or Position	:	SPEECH/LANGUAGE PATHOLOGIST
Name	:	JENNIFER WHITFIELD
Credential	:	MS CCC-SLP
Telephone Number	:	520-631-1978

Provider Enumeration Date	:	02/25/2009
Last Update Date	:	02/25/2009

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Directions to “ARIZONA SPEECH ASSOCIATES ” Practice Location

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