Healthcare Provider Details

I. General information

NPI: 1770487803
Provider Name (Legal Business Name): GLORIA TERESA OROZCO RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3421 E CONSTANCE WAY
PHOENIX AZ
85042-0012
US

IV. Provider business mailing address

3421 E CONSTANCE WAY
PHOENIX AZ
85042-0012
US

V. Phone/Fax

Practice location:
  • Phone: 856-816-7181
  • Fax: 602-532-7438
Mailing address:
  • Phone: 856-816-7181
  • Fax: 602-532-7438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA17926
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: