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General NPI Number Information
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NPI Number | 1235853326
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Entity Type | Organization
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Legal Business Name | EVOLVE THERAPY & WELLNESS LLC
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Dates
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Enumeration Date | 10/03/2022
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Last Update Date | 04/27/2023
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Provider Practice Location Address
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Address Line | 8040 E MORGAN TRL STE 10A
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-1221
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Country | US
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Telephone | 480-219-6977
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Fax |
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Provider Business Mailing Address
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Address Line | 8040 E MORGAN TRL STE 10A
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-1221
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Country | US
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Telephone | 480-219-6977
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIFFANY FOUGHT
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Credential | MS CCC-SLP OTR/L OTD
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Telephone | 602-758-0800
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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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