Healthcare Provider Details

I. General information

NPI: 1841126182
Provider Name (Legal Business Name): CARLY ARIELLE DOTY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20033 N 19TH AVE BLDG 5
PHOENIX AZ
85027-4262
US

IV. Provider business mailing address

28839 N 46TH WAY
CAVE CREEK AZ
85331-2226
US

V. Phone/Fax

Practice location:
  • Phone: 602-875-5616
  • Fax:
Mailing address:
  • Phone: 602-694-2323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA17547
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: