Nancy Jane Martin, CCC-SP

Individual provider Active NPI Speech-Language Pathologist · Sun Lakes, AZ

NPI 1407079296 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1407079296
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SLP5137 (AZ)
Practice address
24628 S Lakeway Cir SE
Sun Lakes, AZ 85248-7311
Phone
(480) 802-9312
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SLP5137AZMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP5137 AZ Yes

Addresses

Primary practice location

24628 S Lakeway Cir SE
Sun Lakes, AZ 85248-7311

Mailing address

24628 S Lakeway Cir SE
Sun Lakes, AZ 85248-7311
Phone (480) 802-9312

Other providers in Sun Lakes, AZ

All providers in Sun Lakes, AZ · Speech-Language Pathologist in Arizona

Sources for this page

Verify at the official NPI Registry.