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General NPI Number Information
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NPI Number | 1003049297
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Entity Type | Organization
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Legal Business Name | SURPRISE THERAPIES, LLC
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Dates
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Enumeration Date | 09/03/2009
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Last Update Date | 09/03/2009
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Provider Practice Location Address
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Address Line | 15315 W PERSHING ST
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City | SURPRISE
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State | AZ
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Zip | 85379-8159
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Country | US
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Telephone | 623-521-0571
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Fax |
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Provider Business Mailing Address
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Address Line | 15315 W PERSHING ST
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City | SURPRISE
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State | AZ
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Zip | 85379-8159
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Country | US
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Telephone | 623-521-0571
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. MAI LING CHAN
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Credential | MS, CCC-SLP
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Telephone | 623-521-0571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225A00000X
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Taxonomy Name | Music Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SPL5051
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License Number State | AZ
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