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General NPI Number Information
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NPI Number | 1104591684
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Entity Type | Organization
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Legal Business Name | PERALTA SPEECH THERAPY, LLC
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Dates
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Enumeration Date | 08/16/2021
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 4148 E SANDY WAY
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City | GILBERT
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State | AZ
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Zip | 85297-2496
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Country | US
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Telephone | 602-315-2401
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Fax |
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Provider Business Mailing Address
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Address Line | 4148 E SANDY WAY
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City | GILBERT
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State | AZ
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Zip | 85297-2496
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Country | US
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Telephone | 602-315-2401
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CHELSEA LYNN PERALTA
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Credential | SLP
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Telephone | 602-315-2401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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 #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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