Provider Demographics
NPI:1578961033
Name:SCHEURICH, GRETCHEN ALANE (MA-CCC/SLP)
Entity Type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:ALANE
Last Name:SCHEURICH
Suffix:
Gender:F
Credentials:MA-CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 S SETON AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-7655
Mailing Address - Country:US
Mailing Address - Phone:480-748-3057
Mailing Address - Fax:
Practice Address - Street 1:3020 S SETON AVE
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-7655
Practice Address - Country:US
Practice Address - Phone:480-748-3057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP1619235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist