Healthcare Provider Details

I. General information

NPI: 1386580850
Provider Name (Legal Business Name): ERIN EVELYN MALES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 N 36TH ST STE 125A
PHOENIX AZ
85018-3456
US

IV. Provider business mailing address

19401 N 9TH PL
PHOENIX AZ
85024-1753
US

V. Phone/Fax

Practice location:
  • Phone: 602-224-0202
  • Fax:
Mailing address:
  • Phone: 602-616-0207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA17220
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: