Healthcare Provider Details

I. General information

NPI: 1851208987
Provider Name (Legal Business Name): ANALYCE LICHELLE BRINKERHOFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

2830 E BROWN RD
MESA AZ
85213-5430
US

IV. Provider business mailing address

21944 E DOMINGO RD
QUEEN CREEK AZ
85142-4592
US

V. Phone/Fax

Practice location:
  • Phone: 602-875-5608
  • Fax:
Mailing address:
  • Phone: 480-339-9671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA17853
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: