Healthcare Provider Details

I. General information

NPI: 1669397527
Provider Name (Legal Business Name): MIKAELA MILLION CORONA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10631 S 51ST ST STE 1
PHOENIX AZ
85044-5225
US

IV. Provider business mailing address

PO BOX 50218
PHOENIX AZ
85076-0218
US

V. Phone/Fax

Practice location:
  • Phone: 480-398-4280
  • Fax: 844-526-2649
Mailing address:
  • Phone: 480-398-4280
  • Fax: 844-526-2649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA17161
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: