Healthcare Provider Details
I. General information
NPI: 1912728783
Provider Name (Legal Business Name): CHIT CHAT CONMIGO SLP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/23/2024
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11114 E SAHUARO DR
SCOTTSDALE AZ
85259-3993
US
IV. Provider business mailing address
11114 E SAHUARO DR
SCOTTSDALE AZ
85259-3993
US
V. Phone/Fax
- Phone: 520-264-8426
- Fax:
- Phone: 520-264-8426
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LORENA
HAUSERMANN
Title or Position: OWNER
Credential: CCC-SLP
Phone: 480-821-3601