Provider Demographics
NPI:1952500829
Name:FINNEFROCK, NADINE ELISABETH
Entity Type:Individual
Prefix:MRS
First Name:NADINE
Middle Name:ELISABETH
Last Name:FINNEFROCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 W CHANDLER BLVD
Mailing Address - Street 2:APT. 1094
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-3803
Mailing Address - Country:US
Mailing Address - Phone:480-274-2476
Mailing Address - Fax:
Practice Address - Street 1:40300 NORTH SIMOTON BLVD.
Practice Address - Street 2:KATHRYN SUE SIMONTON ELEMENTARY SCHOOL
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85241
Practice Address - Country:US
Practice Address - Phone:480-987-5330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ#SLPL5365235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist