Healthcare Provider Details

I. General information

NPI: 1689172942
Provider Name (Legal Business Name): ASHLEY ELIZABETH WEISS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2018
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 W ELLIOT RD
TEMPE AZ
85284-1310
US

IV. Provider business mailing address

3126 E MULBERRY DR
PHOENIX AZ
85016-7548
US

V. Phone/Fax

Practice location:
  • Phone: 480-296-4229
  • Fax: 480-296-4229
Mailing address:
  • Phone: 480-296-4229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP9598
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: