Healthcare Provider Details

I. General information

NPI: 1750201117
Provider Name (Legal Business Name): ALYCIA ELENA TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W SAN TAN HEIGHTS BLVD
SAN TAN VALLEY AZ
85144-4814
US

IV. Provider business mailing address

5167 S BRIDAL VAIL DR
GILBERT AZ
85298-2214
US

V. Phone/Fax

Practice location:
  • Phone: 480-888-7555
  • Fax:
Mailing address:
  • Phone: 480-490-8059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberTSLP17582
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: