Healthcare Provider Details

I. General information

NPI: 1104751239
Provider Name (Legal Business Name): THE THERAPY GARDEN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4824 E BASELINE RD STE 124
MESA AZ
85206-4679
US

IV. Provider business mailing address

4824 E BASELINE RD STE 124
MESA AZ
85206-4679
US

V. Phone/Fax

Practice location:
  • Phone: 480-740-9536
  • Fax:
Mailing address:
  • Phone: 480-740-9536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: BROOKLYN BENSON
Title or Position: OWNER OPERATOR
Credential: M.S CCC-SLP
Phone: 480-740-9536