Provider Demographics
NPI:1194031112
Name:CURRY, TISA
Entity Type:Individual
Prefix:
First Name:TISA
Middle Name:
Last Name:CURRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 S SANDSTONE ST
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-4825
Mailing Address - Country:US
Mailing Address - Phone:480-782-0272
Mailing Address - Fax:480-840-6808
Practice Address - Street 1:1935 S SANDSTONE ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-4825
Practice Address - Country:US
Practice Address - Phone:480-782-0272
Practice Address - Fax:480-840-6808
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP6651235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist