Healthcare Provider Details

I. General information

NPI: 1710341979
Provider Name (Legal Business Name): CATALYST THERAPY SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2016
Last Update Date: 04/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18213 N SKYHAWK DR
SURPRISE AZ
85374-4402
US

IV. Provider business mailing address

18213 N SKYHAWK DR
SURPRISE AZ
85374-4402
US

V. Phone/Fax

Practice location:
  • Phone: 623-363-1533
  • Fax:
Mailing address:
  • Phone: 623-363-1533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSPLA 8398
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP6845
License Number StateAZ

VIII. Authorized Official

Name: CHARLOTTE ELOISE VALDIZAN
Title or Position: OWNER/PARTNER
Credential: M.A.,CCC-SLP/L
Phone: 623-363-1533