Provider Demographics
NPI:1598998163
Name:MARTIN-BUNTING, MARGARET (PEGGY) JOSEPHINE (MA SPEECH THERAPY)
Entity type:Individual
Prefix:MRS
First Name:MARGARET (PEGGY)
Middle Name:JOSEPHINE
Last Name:MARTIN-BUNTING
Suffix:
Gender:F
Credentials:MA SPEECH THERAPY
Other - Prefix:MISS
Other - First Name:MARGARET (PEGGY)
Other - Middle Name:JOSEPHINE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2922 ECLAIRE DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032
Mailing Address - Country:US
Mailing Address - Phone:602-790-0358
Mailing Address - Fax:602-283-5326
Practice Address - Street 1:2922 E CLAIRE DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-5015
Practice Address - Country:US
Practice Address - Phone:602-790-0358
Practice Address - Fax:602-283-5326
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP6146235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ#SLP6146OtherSPEECH LANGUAGE PATHOLOGIST