Provider Demographics
NPI:1871073460
Name:LENTINE, MARIA (SLPA 11222)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:LENTINE
Suffix:
Gender:F
Credentials:SLPA 11222
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:LENTINE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11207 N 18TH DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-3707
Mailing Address - Country:US
Mailing Address - Phone:602-882-4249
Mailing Address - Fax:
Practice Address - Street 1:6991 E CAMELBACK RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-2432
Practice Address - Country:US
Practice Address - Phone:480-861-1440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ112222355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant