Healthcare Provider Details

I. General information

NPI: 1841141041
Provider Name (Legal Business Name): DESERT SPEECH & FEEDING CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2026
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6300 SAGEWOOD DR STE 426
PARK CITY UT
84098-7502
US

IV. Provider business mailing address

30 N GOULD ST STE R
SHERIDAN WY
82801-6317
US

V. Phone/Fax

Practice location:
  • Phone: 702-447-5453
  • Fax:
Mailing address:
  • Phone: 702-447-5453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: EMILY HARRIS
Title or Position: PRACTICE ADMINISTRATOR (CONTRACT)
Credential: CCC-SLP
Phone: 702-447-5453