Provider Demographics
NPI:1457632853
Name:CHAVEZ, MARIA MARGARITA (SLPA)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:MARGARITA
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 S 11TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85034-4537
Mailing Address - Country:US
Mailing Address - Phone:602-257-3885
Mailing Address - Fax:602-257-3952
Practice Address - Street 1:1350 S 11TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-4537
Practice Address - Country:US
Practice Address - Phone:602-257-3885
Practice Address - Fax:602-257-3952
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ72322355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ7232OtherSLPA