Healthcare Provider Details

I. General information

NPI: 1740698877
Provider Name (Legal Business Name): SUSAN K BABENDURE SLPA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2014
Last Update Date: 08/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7120 E SAHUARO DR ACHIEVEMENT THERAPY SERVICES
SCOTTSDALE AZ
85254
US

IV. Provider business mailing address

32531 N SCOTTSDALE RD SUITE 105-162 ACHIEVEMENT THERAPY SERVICES
SCOTTSDALE AZ
85266-6884
US

V. Phone/Fax

Practice location:
  • Phone: 480-488-3946
  • Fax: 480-488-3956
Mailing address:
  • Phone: 480-488-3946
  • Fax: 480-488-3956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA8991
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: