Healthcare Provider Details

I. General information

NPI: 1447384920
Provider Name (Legal Business Name): GLENDA SCHACHINGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35959 N 7TH AVE
DESERT HILLS AZ
85086-6306
US

IV. Provider business mailing address

9155 N 73RD DR
PEORIA AZ
85345-7188
US

V. Phone/Fax

Practice location:
  • Phone: 623-445-3500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP4670
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: