Healthcare Provider Details

I. General information

NPI: 1114804598
Provider Name (Legal Business Name): DELANEY RICHARDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2025
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2910 E CAMELBACK RD
PHOENIX AZ
85016-4405
US

IV. Provider business mailing address

3202 W WALTER WAY
PHOENIX AZ
85027-1074
US

V. Phone/Fax

Practice location:
  • Phone: 602-956-1233
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number033580
License Number StateAZ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: