Provider Demographics
NPI:1821237496
Name:LAFFERTY, ADDIE E (PHD)
Entity Type:Individual
Prefix:DR
First Name:ADDIE
Middle Name:E
Last Name:LAFFERTY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 871908
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85287-0001
Mailing Address - Country:US
Mailing Address - Phone:480-965-9396
Mailing Address - Fax:480-965-0965
Practice Address - Street 1:200 E CURRY RD
Practice Address - Street 2:STE 146
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85287-0001
Practice Address - Country:US
Practice Address - Phone:480-965-9396
Practice Address - Fax:480-965-0965
Is Sole Proprietor?:No
Enumeration Date:2009-02-05
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP2131235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist