Healthcare Provider Details

I. General information

NPI: 1063341568
Provider Name (Legal Business Name): MADISON TAYLOR VAUPELL
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20414 N 27TH AVE STE 410
PHOENIX AZ
85027-3250
US

IV. Provider business mailing address

5527 E JANICE WAY
SCOTTSDALE AZ
85254-8214
US

V. Phone/Fax

Practice location:
  • Phone: 720-443-4958
  • Fax:
Mailing address:
  • Phone: 720-443-4958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP17298
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: