Provider Demographics
NPI:1659410397
Name:SOTO, CLAUDIA LIZETTE
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:LIZETTE
Last Name:SOTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4921 W PASEO DE LAS COLINAS
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-9239
Mailing Address - Country:US
Mailing Address - Phone:520-891-6454
Mailing Address - Fax:
Practice Address - Street 1:4921 W PASEO DE LAS COLINAS
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-9239
Practice Address - Country:US
Practice Address - Phone:520-891-6454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPL4876235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ118713Medicaid