Provider Demographics
NPI:1649327388
Name:HOMCO, NANCY P (SPL)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:P
Last Name:HOMCO
Suffix:
Gender:F
Credentials:SPL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7415 N 59TH AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301-1823
Mailing Address - Country:US
Mailing Address - Phone:623-463-7878
Mailing Address - Fax:602-866-2261
Practice Address - Street 1:7415 N 59TH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-1823
Practice Address - Country:US
Practice Address - Phone:623-463-7878
Practice Address - Fax:602-866-2261
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP1460235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist