Healthcare Provider Details

I. General information

NPI: 1013838614
Provider Name (Legal Business Name): TAMARA ELLYN-SOPHIA GALAS-WARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8800 S 55TH AVE
LAVEEN AZ
85339-3048
US

IV. Provider business mailing address

5001 W DOBBINS RD
LAVEEN AZ
85339-9733
US

V. Phone/Fax

Practice location:
  • Phone: 602-304-2040
  • Fax: 602-304-2045
Mailing address:
  • Phone: 602-237-9100
  • Fax: 602-237-9135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLP16883
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: