Healthcare Provider Details

I. General information

NPI: 1952665796
Provider Name (Legal Business Name): LOOK WHO'S TALKING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2012
Last Update Date: 06/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22665 S 194TH WAY
QUEEN CREEK AZ
85142-8970
US

IV. Provider business mailing address

22665 S 194TH WAY
QUEEN CREEK AZ
85142-8970
US

V. Phone/Fax

Practice location:
  • Phone: 480-390-8746
  • Fax: 480-279-3518
Mailing address:
  • Phone: 480-390-8746
  • Fax: 480-279-3518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License NumberSLP6212
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberSLP6212
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License NumberSLP6212
License Number StateAZ

VIII. Authorized Official

Name: TIFFANY ROBLEDO
Title or Position: SPEECH PATHOLOGIST, SOLE PROPRIETOR
Credential: M.S., CCC-SLP
Phone: 480-390-8746