Provider Demographics
NPI:1457191710
Name:GARTH, JOLIE LORIN
Entity type:Individual
Prefix:
First Name:JOLIE
Middle Name:LORIN
Last Name:GARTH
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 1:21951 N 97TH GLN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-3339
Mailing Address - Country:US
Mailing Address - Phone:312-285-6206
Mailing Address - Fax:
Practice Address - Street 1:501 W RAY RD STE 1-2
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-7284
Practice Address - Country:US
Practice Address - Phone:480-296-2363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-25
Last Update Date:2024-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant