Healthcare Provider Details

I. General information

NPI: 1740970417
Provider Name (Legal Business Name): EMMY DANAE TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3160 N ARIZONA AVE STE 105
CHANDLER AZ
85225-7122
US

IV. Provider business mailing address

37884 N NEATWOOD DR
SAN TAN VALLEY AZ
85140-0119
US

V. Phone/Fax

Practice location:
  • Phone: 480-365-9811
  • Fax:
Mailing address:
  • Phone: 928-965-4401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberTSLP17408
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: