Provider Demographics
NPI:1255510079
Name:GLENN, VERONICA SAENZ (SLP)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:SAENZ
Last Name:GLENN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1590 W DESERT BROOM DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-3668
Mailing Address - Country:US
Mailing Address - Phone:480-726-3404
Mailing Address - Fax:480-963-3860
Practice Address - Street 1:1590 W DESERT BROOM DR
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-3668
Practice Address - Country:US
Practice Address - Phone:480-726-3404
Practice Address - Fax:480-963-3860
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP1338235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ123456Medicaid