| Doctor Name: | MRS. MARY SHARYLE GAGNEPAIN |
| NPI Number: | 1033240585 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP |
| License Number: | #SLPL0183 |
| Business Practice Address: | 8430 N 39th Ave Phoenix, AZ - 850514778 |
| Business Phone Number: | 6023472235 |
| Business Fax Number: | 6023472220 |
| Mailing Address: | 3109 N 46th Pl, PHOENIX |
| State: | AZ |
| Postal Code: | 850186535 |
| Phone Number: | 6023472235 |
| Fax Number: | 6023472220 |
| NPI Enumeration Date: | 03/08/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | #SLPL0183 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |