MEDICARE: MRS. MONA HELEN CHENEY-TUNTLAND M.S.

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	235Z00000X	Speech-Language Pathologist	0007	AZ

General Provider Information

NPI Number	:	1467575597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MONA HELEN CHENEY-TUNTLAND M.S.

Provider Business Mailing Address
First Line	:	1020 E VERMONT AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85014-2607
Country	:	US
Telephone Number	:	602-285-9475
Fax Number	:

Provider Business Practice Location Address
First Line	:	4650 W. SWEETWATER AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85304
Country	:	US
Telephone Number	:	602-347-2244
Fax Number	:

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

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	09/05/2008

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