Healthcare Provider Details

I. General information

NPI: 1841336278
Provider Name (Legal Business Name): KAREN THERESA BRYANT M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12121 N 124TH ST
SCOTTSDALE AZ
85259-3473
US

IV. Provider business mailing address

10787 N 103RD WAY
SCOTTSDALE AZ
85260-6315
US

V. Phone/Fax

Practice location:
  • Phone: 480-484-7300
  • Fax: 480-484-7301
Mailing address:
  • Phone: 480-391-2729
  • Fax: 480-484-7301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP 0433
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: