Healthcare Provider Details
I. General information
NPI: 1003727967
Provider Name (Legal Business Name): ISABELLE MARIE UGARTE MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1830 S ALMA SCHOOL RD STE 122
MESA AZ
85210-3087
US
IV. Provider business mailing address
10410 N CAVE CREEK RD UNIT 2126
PHOENIX AZ
85020-1664
US
V. Phone/Fax
- Phone: 480-361-8355
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | TSLP17903 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: