Healthcare Provider Details

I. General information

NPI: 1659109023
Provider Name (Legal Business Name): ELENA WEIER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2024
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5312 W MOUNTAIN VIEW RD
GLENDALE AZ
85302-2200
US

IV. Provider business mailing address

6330 W THUNDERBIRD RD
GLENDALE AZ
85306-4002
US

V. Phone/Fax

Practice location:
  • Phone: 623-412-4525
  • Fax:
Mailing address:
  • Phone: 623-486-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP16374
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: