Provider Demographics
NPI:1215916820
Name:SAXTON, CLINTON MICHAEL (MS,CCC-SLP)
Entity type:Individual
Prefix:MR
First Name:CLINTON
Middle Name:MICHAEL
Last Name:SAXTON
Suffix:
Gender:M
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38418 N 12TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-4802
Mailing Address - Country:US
Mailing Address - Phone:623-465-5489
Mailing Address - Fax:
Practice Address - Street 1:1802 W PARKSIDE LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-1322
Practice Address - Country:US
Practice Address - Phone:602-943-5472
Practice Address - Fax:602-943-4936
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1174235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist