Doctor Name: | SHARON LOUISE CROUSE-MATLOCK |
NPI Number: | 1568871374 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | TSLP8957 |
Business Practice Address: | 16428 E Kingstree Blvd Fountain Hills, AZ - 852685440 |
Business Phone Number: | 4808374565 |
Business Fax Number: | 8889578277 |
Mailing Address: | 1665 Cushman Dr, SIERRA VISTA |
State: | AZ |
Postal Code: | 856352146 |
Phone Number: | 5204959768 |
Fax Number: | |
NPI Enumeration Date: | 08/06/2014 |
NPI Last Update Date: | 08/06/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | TSLP8957 |
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 |