Provider Demographics
NPI:1205023603
Name:ARCHER, CADIE M (BS)
Entity Type:Individual
Prefix:
First Name:CADIE
Middle Name:M
Last Name:ARCHER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4243 W CALVA DRAW PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-4101
Mailing Address - Country:US
Mailing Address - Phone:520-400-6275
Mailing Address - Fax:
Practice Address - Street 1:5000 E ANDREW ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-6448
Practice Address - Country:US
Practice Address - Phone:520-584-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLTL5667235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist