Healthcare Provider Details

I. General information

NPI: 1164596284
Provider Name (Legal Business Name): ACCEL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 10/11/2022
Certification Date: 10/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10251 N. 35TH AVE
PHOENIX AZ
85051
US

IV. Provider business mailing address

10251 N. 35TH AVE
PHOENIX AZ
85051
US

V. Phone/Fax

Practice location:
  • Phone: 602-926-7210
  • Fax: 602-268-2730
Mailing address:
  • Phone: 602-926-7210
  • Fax: 602-268-2730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number6265
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBA11
License Number StateAZ
# 5
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. CONNIE FLETCHER LAIRD
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 602-995-7366