Healthcare Provider Details

I. General information

NPI: 1285543504
Provider Name (Legal Business Name): ISABELLA ROSE PERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1337 S GILBERT RD STE 105
MESA AZ
85204-6074
US

IV. Provider business mailing address

1337 S GILBERT RD STE 105
MESA AZ
85204-6074
US

V. Phone/Fax

Practice location:
  • Phone: 480-530-0890
  • Fax:
Mailing address:
  • Phone: 480-530-0890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA17811
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: