Healthcare Provider Details

I. General information

NPI: 1003733205
Provider Name (Legal Business Name): SARA EMILY CRUZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7776 S POINTE PKWY W STE 250
PHOENIX AZ
85044-5428
US

IV. Provider business mailing address

1811 E APACHE BLVD APT 3039
TEMPE AZ
85281-6131
US

V. Phone/Fax

Practice location:
  • Phone: 480-518-7073
  • Fax: 480-564-5775
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA17403
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: