Healthcare Provider Details

I. General information

NPI: 1215851639
Provider Name (Legal Business Name): KAYLEE MORGAN RICHINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KAYLEE MORGAN BARGAR

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43507 N IRONWOOD DR
QUEEN CREEK AZ
85140-9312
US

IV. Provider business mailing address

1045 E NARDINI ST
SAN TAN VALLEY AZ
85140-7405
US

V. Phone/Fax

Practice location:
  • Phone: 480-757-2253
  • Fax:
Mailing address:
  • Phone: 480-276-8067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: