Doctor Name: | ANN CARLSON-WILLETTE |
NPI Number: | 1841624061 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA CCC-SLP |
License Number: | SLP7498 |
Business Practice Address: | 146 S Granite St Prescott, AZ - 863034710 |
Business Phone Number: | 9284455400 |
Business Fax Number: | |
Mailing Address: | 1716 Alpine Meadows Ln, # 103 PRESCOTT |
State: | AZ |
Postal Code: | 863034969 |
Phone Number: | 7602852130 |
Fax Number: | |
NPI Enumeration Date: | 08/23/2013 |
NPI Last Update Date: | 08/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP7498 |
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 |