Provider Demographics
NPI:1568823599
Name:SONORAN SPEECH SERVICES
Entity Type:Organization
Organization Name:SONORAN SPEECH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:KEMERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-502-4397
Mailing Address - Street 1:629 N 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85003-1530
Mailing Address - Country:US
Mailing Address - Phone:719-209-8166
Mailing Address - Fax:
Practice Address - Street 1:417 E TIERRA BUENA LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-3034
Practice Address - Country:US
Practice Address - Phone:602-502-4397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-18
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA9788251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health