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MR. ROBERT OTIS BRANCH SPEECH PATHOLOGIST

>> Speech-Language Pathologist >> Speech, Language and Hearing Service Providers

Registrant NPI Number: 1366580862

Individual Registrant:
MR. ROBERT OTIS BRANCH SPEECH PATHOLOGIST
Gender: M
Sole Proprietor

Location and contact information for practice:
11279 W. GRIER RD. MUSD SPECIAL EDUCATION, MARANA, AZ 85653 US
Tel: 520-682-4782  Fax: 520-682-4818

Contact information for business:
14450 N SWAN RD  TUCSON, AZ 85739-9103 US
Tel: 520-825-2956  Fax: --

Registration Information:
NPI: 1366580862
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y235Z00000XSpeech, Language and Hearing Service Providers
Speech-Language Pathologist
AZSLP0644

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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