Provider Demographics
NPI:1881802346
Name:MORALES DE FITZGERALD, IZLIA A (MS)
Entity type:Individual
Prefix:MRS
First Name:IZLIA
Middle Name:A
Last Name:MORALES DE FITZGERALD
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MR
Other - First Name:IZLIA
Other - Middle Name:M
Other - Last Name:FITZGERALD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:45012 W HONEYCUTT AVE
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85239-2842
Mailing Address - Country:US
Mailing Address - Phone:520-568-8118
Mailing Address - Fax:
Practice Address - Street 1:45012 W HONEYCUTT AVE
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85239-2842
Practice Address - Country:US
Practice Address - Phone:520-568-8118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPL 5495235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist