Healthcare Provider Details

I. General information

NPI: 1679490148
Provider Name (Legal Business Name): CHELSEY BUONOCORE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12020 N 35TH AVE STE 109
PHOENIX AZ
85029-3213
US

IV. Provider business mailing address

21918 N 259TH LN
BUCKEYE AZ
85396-5460
US

V. Phone/Fax

Practice location:
  • Phone: 602-780-1179
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: