Provider Demographics
NPI:1578218830
Name:RITCHEY, SAVANNAH LEIGH (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:LEIGH
Last Name:RITCHEY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1385 W UNIVERSITY AVE UNIT 289
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-7143
Mailing Address - Country:US
Mailing Address - Phone:310-427-9240
Mailing Address - Fax:
Practice Address - Street 1:1385 W UNIVERSITY AVE UNIT 289
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-7143
Practice Address - Country:US
Practice Address - Phone:310-427-9240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-15
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP12633235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist