Provider Demographics
NPI:1275668246
Name:VALADEZ, SONIA IVETTE (MS CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:SONIA
Middle Name:IVETTE
Last Name:VALADEZ
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2281 S KAREN DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-2518
Mailing Address - Country:US
Mailing Address - Phone:480-917-2109
Mailing Address - Fax:
Practice Address - Street 1:1001 N 31ST AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85009-3437
Practice Address - Country:US
Practice Address - Phone:602-442-3200
Practice Address - Fax:602-442-3299
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ#SLP2015235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ646200Medicaid