Healthcare Provider Details

I. General information

NPI: 1376943498
Provider Name (Legal Business Name): CHILDREN'S THERAPY SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2014
Last Update Date: 08/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3727 W SAN JUAN AVE
PHOENIX AZ
85019-2113
US

IV. Provider business mailing address

3727 W SAN JUAN AVE
PHOENIX AZ
85019-2113
US

V. Phone/Fax

Practice location:
  • Phone: 602-384-0815
  • Fax:
Mailing address:
  • Phone: 602-384-0815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: EMILIE WILLIS
Title or Position: CEO
Credential: MHS CCC-SLP
Phone: 602-384-0815