Doctor Name: | JOANNA DUB |
NPI Number: | 1285017970 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SLPA9304 |
Business Practice Address: | 4870 N Litchfield Rd Litchfield Park, AZ - 853405041 |
Business Phone Number: | 6232999442 |
Business Fax Number: | |
Mailing Address: | 18646 W Onyx Ave, WADDELL |
State: | AZ |
Postal Code: | 853554447 |
Phone Number: | 5163530585 |
Fax Number: | |
NPI Enumeration Date: | 06/30/2015 |
NPI Last Update Date: | 06/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2355S0801X |
License Number: | SLPA9304 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Specialist/Technologist |
Taxonomy Specialization: | Speech-Language Assistant |
Taxonomy Definition: |