Healthcare Provider Details
I. General information
NPI: 1609798818
Provider Name (Legal Business Name): EVA ANNIKA MYLLYKOSKI BS, SLPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1840 N 95TH AVE STE 140
PHOENIX AZ
85037-4446
US
IV. Provider business mailing address
3500 DEPAUW BLVD STE 3070
INDIANAPOLIS IN
46268-6135
US
V. Phone/Fax
- Phone: 623-264-8188
- Fax: 317-520-8200
- Phone: 855-324-0885
- Fax: 317-520-8200
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2355S0801X |
| Taxonomy | Speech-Language Assistant |
| License Number | SLPA17406 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: