Provider Demographics
NPI:1285890780
Name:STATS-CALDWELL, DENISE (MA, CCC-SLP)
Entity type:Individual
Prefix:PROF
First Name:DENISE
Middle Name:
Last Name:STATS-CALDWELL
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 S. MYRTLE AVE.
Mailing Address - Street 2:ASU - SPEECH & HEARING SCIENCE
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281
Mailing Address - Country:US
Mailing Address - Phone:480-965-3307
Mailing Address - Fax:480-965-0076
Practice Address - Street 1:975 S. MYRTLE AVE.
Practice Address - Street 2:ASU - SPEECH & HEARING SCIENCE
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281
Practice Address - Country:US
Practice Address - Phone:480-965-3307
Practice Address - Fax:480-965-0076
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1091235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist