Healthcare Provider Details

I. General information

NPI: 1144530031
Provider Name (Legal Business Name): ARIEL HEGEDUS SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2010
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 W LOMITA AVE
GLENDALE CA
91204-1512
US

IV. Provider business mailing address

440 W LOMITA AVE
GLENDALE CA
91204-1512
US

V. Phone/Fax

Practice location:
  • Phone: 347-439-3713
  • Fax:
Mailing address:
  • Phone: 347-439-3713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number19042
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: