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General NPI Number Information
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NPI Number | 1215766951
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Entity Type | Organization
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Legal Business Name | FOUR PEAKS THERAPY
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Dates
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Enumeration Date | 07/31/2024
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 10633 E APACHE TRL STE 106
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City | APACHE JUNCTION
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State | AZ
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Zip | 85120-3383
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Country | US
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Telephone | 480-818-8305
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7323
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City | MESA
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State | AZ
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Zip | 85216-7323
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Country | US
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Telephone | 480-818-5305
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LISA COLEMAN
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Credential | COTA/L
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Telephone | 480-818-5305
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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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 | 2355S0801X
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Taxonomy Name | Speech-Language 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 | 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 #5
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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 #6
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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 #7
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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