Provider Demographics
NPI:1720592827
Name:FERRIERA, MARY CHRISTINE (AUD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:CHRISTINE
Last Name:FERRIERA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 E BEARDSLEY RD STE 260
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-1287
Mailing Address - Country:US
Mailing Address - Phone:602-802-8240
Mailing Address - Fax:602-802-8245
Practice Address - Street 1:2340 E BEARDSLEY RD STE 260
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85024-1287
Practice Address - Country:US
Practice Address - Phone:602-802-8240
Practice Address - Fax:602-802-8245
Is Sole Proprietor?:No
Enumeration Date:2017-11-28
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10811231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist