Provider Demographics
NPI:1043526387
Name:PERZ, STEPHANIE (SLP-A)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:
Last Name:PERZ
Suffix:
Gender:F
Credentials:SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 E RIO SALADO PKWY
Mailing Address - Street 2:#1029
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-3038
Mailing Address - Country:US
Mailing Address - Phone:219-794-5801
Mailing Address - Fax:
Practice Address - Street 1:1745 S ALMA SCHOOL RD
Practice Address - Street 2:#145
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-3009
Practice Address - Country:US
Practice Address - Phone:480-963-3634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA65082355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant