Provider Demographics
NPI:1033375175
Name:MEJEUR, JUDY L (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:L
Last Name:MEJEUR
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13272 N HERITAGE CLUB PL
Mailing Address - Street 2:
Mailing Address - City:MARANA
Mailing Address - State:AZ
Mailing Address - Zip Code:85658-4142
Mailing Address - Country:US
Mailing Address - Phone:520-344-9050
Mailing Address - Fax:
Practice Address - Street 1:12279 W. GRIER RD.
Practice Address - Street 2:MUSD SPECIAL EDUCATION
Practice Address - City:MARANA
Practice Address - State:AZ
Practice Address - Zip Code:85653
Practice Address - Country:US
Practice Address - Phone:520-682-4782
Practice Address - Fax:520-682-4818
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP5933235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist