Provider Demographics
NPI:1619163490
Name:GUERRERO, VIRGINIA LEE (MA, L-CF-SLP)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:LEE
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:MA, L-CF-SLP
Other - Prefix:
Other - First Name:GINNY
Other - Middle Name:
Other - Last Name:GUERRERO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, L-CF-SLP
Mailing Address - Street 1:16428 E KINGSTREE BLVD
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-5440
Mailing Address - Country:US
Mailing Address - Phone:480-224-3400
Mailing Address - Fax:480-224-3420
Practice Address - Street 1:5990 S VAL VISTA DR
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-9028
Practice Address - Country:US
Practice Address - Phone:480-224-3400
Practice Address - Fax:480-224-3420
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP5616235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist