Provider Demographics
NPI:1720233380
Name:COVARRUBIAS, NANCY A (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:A
Last Name:COVARRUBIAS
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 1:6341 E 34TH AVE
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85219-7859
Mailing Address - Country:US
Mailing Address - Phone:480-984-4033
Mailing Address - Fax:
Practice Address - Street 1:6341 E 34TH AVE
Practice Address - Street 2:
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85219-7859
Practice Address - Country:US
Practice Address - Phone:480-984-4033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP5889235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist