Healthcare Provider Details

I. General information

NPI: 1326710948
Provider Name (Legal Business Name): MARY KENZ MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2021
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 E JACKRABBIT RD
SCOTTSDALE AZ
85250-6730
US

IV. Provider business mailing address

11455 S ONEIDA ST
PHOENIX AZ
85044-1816
US

V. Phone/Fax

Practice location:
  • Phone: 480-484-6100
  • Fax:
Mailing address:
  • Phone: 626-261-3046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP12734
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: