Healthcare Provider Details

I. General information

NPI: 1669533105
Provider Name (Legal Business Name): SOLACE PEDIATRIC HEALTHCARE THERAPY SERVICES AZ, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 E RIO SALADO PKWY STE 900
TEMPE AZ
85281-9126
US

IV. Provider business mailing address

60 E RIO SALADO PKWY STE 900
TEMPE AZ
85281-9126
US

V. Phone/Fax

Practice location:
  • Phone: 480-456-0719
  • Fax: 480-456-0163
Mailing address:
  • Phone: 480-456-0719
  • Fax: 480-456-0163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: LINDSAY MILLER
Title or Position: REGIONAL DIRECTOR OF COMPLIANCE
Credential:
Phone: 303-432-8487