Healthcare Provider Details

I. General information

NPI: 1760183743
Provider Name (Legal Business Name): TONGUE TWISTERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2023
Last Update Date: 03/15/2023
Certification Date: 03/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4824 E BASELINE RD STE 140
MESA AZ
85206-4680
US

IV. Provider business mailing address

4824 E BASELINE RD STE 140
MESA AZ
85206-4680
US

V. Phone/Fax

Practice location:
  • Phone: 480-482-7098
  • Fax: 480-830-1042
Mailing address:
  • Phone: 480-482-7098
  • Fax: 480-830-1042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: DAVID ALEXANDER WARKENTIN
Title or Position: OWNER
Credential: DC
Phone: 310-770-6368