Healthcare Provider Details

I. General information

NPI: 1396592523
Provider Name (Legal Business Name): SIM SPEECH THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6418 E JENAN DR
SCOTTSDALE AZ
85254-5054
US

IV. Provider business mailing address

6418 E JENAN DR
SCOTTSDALE AZ
85254-5054
US

V. Phone/Fax

Practice location:
  • Phone: 480-779-7866
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. SASHA MILUTINOVIC
Title or Position: MEMBER
Credential:
Phone: 480-779-7866