Healthcare Provider Details

I. General information

NPI: 1922614148
Provider Name (Legal Business Name): BRANDI MAY WHITE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2020
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35856 N MURRAY GREY DR
SAN TAN VALLEY AZ
85143-5548
US

IV. Provider business mailing address

21449 S 230TH ST
QUEEN CREEK AZ
85142-0824
US

V. Phone/Fax

Practice location:
  • Phone: 480-382-5699
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA12197
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: