Provider Demographics
NPI:1447969597
Name:WARD, AQUILA (BS, SLPA)
Entity type:Individual
Prefix:
First Name:AQUILA
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:BS, SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4719 QUAIL LAKES DR # G240
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-8140
Mailing Address - Country:US
Mailing Address - Phone:209-952-2588
Mailing Address - Fax:
Practice Address - Street 1:3031 W MARCH LN STE 117S
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95219-6500
Practice Address - Country:US
Practice Address - Phone:209-952-2588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant