Provider Demographics
NPI:1588328348
Name:ARNOLD, LAQUISHA DEVINE
Entity type:Individual
Prefix:
First Name:LAQUISHA
Middle Name:DEVINE
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20050 N CAVE CREEK RD APT 234
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-5418
Mailing Address - Country:US
Mailing Address - Phone:480-440-2422
Mailing Address - Fax:
Practice Address - Street 1:21630 N 19TH AVE STE B3
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-2717
Practice Address - Country:US
Practice Address - Phone:602-875-5616
Practice Address - Fax:623-227-2030
Is Sole Proprietor?:No
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA134042355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant