Healthcare Provider Details

I. General information

NPI: 1922719954
Provider Name (Legal Business Name): MALIA SIDLER CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2022
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3033 N 44TH ST STE 210
PHOENIX AZ
85018-7244
US

IV. Provider business mailing address

1803 N PALM DR
TEMPE AZ
85288-1443
US

V. Phone/Fax

Practice location:
  • Phone: 623-263-3966
  • Fax:
Mailing address:
  • Phone: 480-390-4505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberTSLP17463
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: