Provider Demographics
NPI:1427270784
Name:CHAVANNES, GENEVIEVE (SPEECH LANGUAGE PATH)
Entity type:Individual
Prefix:MRS
First Name:GENEVIEVE
Middle Name:
Last Name:CHAVANNES
Suffix:
Gender:F
Credentials:SPEECH LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17510 W WIND SONG AVE
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-5804
Mailing Address - Country:US
Mailing Address - Phone:623-327-1681
Mailing Address - Fax:
Practice Address - Street 1:17510 W WIND SONG AVE
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-5804
Practice Address - Country:US
Practice Address - Phone:623-327-1681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist