Healthcare Provider Details

I. General information

NPI: 1952247728
Provider Name (Legal Business Name): EAST VALLEY SPEECH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1156 N SETON AVE
GILBERT AZ
85234-2123
US

IV. Provider business mailing address

1156 N SETON AVE
GILBERT AZ
85234-2123
US

V. Phone/Fax

Practice location:
  • Phone: 480-776-4896
  • Fax:
Mailing address:
  • Phone: 480-776-4896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: STEFANIE DOUGLAS
Title or Position: CEO
Credential:
Phone: 480-577-6352