Healthcare Provider Details

I. General information

NPI: 1669385696
Provider Name (Legal Business Name): CLAIRE GLENNON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 W RAY RD STE 1-3
CHANDLER AZ
85225-7284
US

IV. Provider business mailing address

3562 N TIROL CIR
MESA AZ
85215-4216
US

V. Phone/Fax

Practice location:
  • Phone: 480-296-2363
  • Fax: 480-685-9875
Mailing address:
  • Phone: 602-693-5334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA16033
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: