Provider Demographics
NPI:1124521752
Name:POSTON, CHARLES BRADLEY
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:BRADLEY
Last Name:POSTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7866 W SPUR DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-6215
Mailing Address - Country:US
Mailing Address - Phone:602-330-5494
Mailing Address - Fax:
Practice Address - Street 1:3516 E ASHURST DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-7854
Practice Address - Country:US
Practice Address - Phone:602-524-2860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-09
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant