Healthcare Provider Details

I. General information

NPI: 1578181079
Provider Name (Legal Business Name): MICAELA MUEHLICH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2020
Last Update Date: 04/03/2026
Certification Date: 07/16/2020
Deactivation Date: 10/27/2025
Reactivation Date: 04/03/2026

III. Provider practice location address

21630 N 19TH AVE
PHOENIX AZ
85027-2719
US

IV. Provider business mailing address

4239 E RANCHO TIERRA DR
CAVE CREEK AZ
85331-7867
US

V. Phone/Fax

Practice location:
  • Phone: 602-875-5616
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number12454
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: