Provider Demographics
NPI:1538411566
Name:SONORAN SPEECH WORKS, LLC
Entity type:Organization
Organization Name:SONORAN SPEECH WORKS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOLGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:AIDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:520-245-3539
Mailing Address - Street 1:10959 E MESQUITE VALLEY TRL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85749-6710
Mailing Address - Country:US
Mailing Address - Phone:520-245-3539
Mailing Address - Fax:520-760-9454
Practice Address - Street 1:10959 E MESQUITE VALLEY TRL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85749-6710
Practice Address - Country:US
Practice Address - Phone:520-245-3539
Practice Address - Fax:520-760-9454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-15
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2355S0801X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty