Healthcare Provider Details

I. General information

NPI: 1609713353
Provider Name (Legal Business Name): RIDA SHAKEEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8222 S 48TH ST STE 236
PHOENIX AZ
85044-5369
US

IV. Provider business mailing address

3351 E WISTERIA PL
CHANDLER AZ
85286-0165
US

V. Phone/Fax

Practice location:
  • Phone: 602-412-7232
  • Fax: 623-872-6087
Mailing address:
  • Phone: 602-684-1319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: