Basic Information
| Provider Information | |||||||||
| NPI: | 1518226711 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CULLING | ||||||||
| FirstName: | TRAVIS | ||||||||
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| Credential: | SLPA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7572 W SPUR DR | ||||||||
| Address2: | |||||||||
| City: | PEORIA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853836210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6026250513 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5314 NORTH 7 STREET | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022775006 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2012 | ||||||||
| LastUpdateDate: | 05/08/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2355S0801X | SLPA 7321 | AZ | Y | Speech, Language and Hearing Service Providers | Specialist/Technologist | Speech-Language Assistant |
No ID Information.