Provider Demographics
NPI:1851555890
Name:RAFIK, PAMELA-SUE TRUESDELL (MS,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:PAMELA-SUE
Middle Name:TRUESDELL
Last Name:RAFIK
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3926 E KERESAN ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-3831
Mailing Address - Country:US
Mailing Address - Phone:602-451-8717
Mailing Address - Fax:480-203-2327
Practice Address - Street 1:3926 E KERESAN ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-3831
Practice Address - Country:US
Practice Address - Phone:602-451-8717
Practice Address - Fax:480-203-2327
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP0663235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist