Provider Demographics
NPI:1891344719
Name:CIVANO SPEECH & LANGUAGE PLLC
Entity Type:Organization
Organization Name:CIVANO SPEECH & LANGUAGE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KALEI
Authorized Official - Middle Name:
Authorized Official - Last Name:HARMON
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:520-665-1818
Mailing Address - Street 1:5293 S RICHARD ASHLEY CIR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85747-5904
Mailing Address - Country:US
Mailing Address - Phone:520-665-1818
Mailing Address - Fax:
Practice Address - Street 1:10510 E SEVEN GENERATIONS WAY
Practice Address - Street 2:STE 204
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85747-8574
Practice Address - Country:US
Practice Address - Phone:520-665-1818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty