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NPI Code Detail

MEDICARE: MRS. BRENDA JEAN DOEKSEN M.S. CCC-SLP

MEDICARE: MRS. BRENDA JEAN DOEKSEN M.S. CCC-SLP
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
1235Z00000XSpeech-Language PathologistSLP2080AZ

General Provider Information

NPI Number : 1750392635
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRENDA JEAN DOEKSEN M.S. CCC-SLP
Provider Business Mailing Address
First Line : 10943 S DREAMY DR
Second Line :
City : GOODYEAR
State : AZ
Zip : 85338-9622
Country : US
Telephone Number : 623-374-4994
Fax Number :
Provider Business Practice Location Address
First Line : 15151 W CENTERRA DR S
Second Line :
City : GOODYEAR
State : AZ
Zip : 85338-2956
Country : US
Telephone Number : 623-772-4800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. BRENDA JEAN DOEKSEN M.S. CCC-SLP” Practice Location

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