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General NPI Number Information
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NPI Number | 1104012392
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Entity Type | Organization
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Legal Business Name | AIM HIGH THERAPY
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Dates
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Enumeration Date | 09/20/2007
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Last Update Date | 09/20/2007
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Provider Practice Location Address
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Address Line | 17017 N 12TH ST APT 1122
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City | PHOENIX
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State | AZ
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Zip | 85022-2094
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Country | US
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Telephone | 480-776-9085
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Fax |
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Provider Business Mailing Address
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Address Line | 17017 N 12TH ST APT 1122
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City | PHOENIX
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State | AZ
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Zip | 85022-2094
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Country | US
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Telephone | 480-776-9085
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Fax |
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Authorized Official
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Title or Position | SPEECH/LANGUAGE PATHOLOGIST/OWNER
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Name | TAMARA ANN HOLTZ
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Credential | M.S., CCC-SLP
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Telephone | 480-776-9085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 4026
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License Number State | AZ
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