=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528955879
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAIME KIRKLAND
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/19/2025
-----------------------------------------------------
Last Update Date | 08/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14362 N FRANK LLOYD WRIGHT BLVD STE 1000
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85260-8847
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-468-6320
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 29646 N GECKO TRL
-----------------------------------------------------
City | SAN TAN VALLEY
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85143-8086
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-903-7691
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2355S0801X
-----------------------------------------------------
Taxonomy Name | Speech-Language Assistant
-----------------------------------------------------
License Number | SLPA16349
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------