Provider Demographics
NPI:1952783565
Name:GREGORY, POLINA (SLPA)
Entity Type:Individual
Prefix:MISS
First Name:POLINA
Middle Name:
Last Name:GREGORY
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 S HARDY DR UNIT 215
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-7805
Mailing Address - Country:US
Mailing Address - Phone:602-510-8303
Mailing Address - Fax:
Practice Address - Street 1:1250 N 77TH ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-3708
Practice Address - Country:US
Practice Address - Phone:480-839-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant