Provider Demographics
NPI:1427564541
Name:SPITLER, DUSTY
Entity Type:Individual
Prefix:MRS
First Name:DUSTY
Middle Name:
Last Name:SPITLER
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 1:1781 E STATE ROUTE 69 STE 65
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-5669
Mailing Address - Country:US
Mailing Address - Phone:928-227-2476
Mailing Address - Fax:
Practice Address - Street 1:1781 E STATE ROUTE 69 STE 65
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-5669
Practice Address - Country:US
Practice Address - Phone:928-227-2476
Practice Address - Fax:928-227-2476
Is Sole Proprietor?:No
Enumeration Date:2017-12-27
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHAD8219237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist