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General NPI Number Information
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NPI Number | 1073454401
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Entity Type | Individual
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Provider Name | MRS. AMY MARIE LEITHOFF
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Gender | Female
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Dates
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Enumeration Date | 04/01/2026
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Last Update Date | 04/01/2026
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Provider Practice Location Address
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Address Line | 3875 E WILLIAMS FIELD RD STE 201
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City | GILBERT
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State | AZ
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Zip | 85295-8700
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Country | US
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Telephone | 480-704-5954
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Fax |
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Provider Business Mailing Address
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Address Line | 3588 E ALAMO ST
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City | SAN TAN VALLEY
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State | AZ
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Zip | 85140-4333
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Country | US
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Telephone | 480-228-4633
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | SLPA17162
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License Number State | AZ
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