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General NPI Number Information
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NPI Number | 1669140539
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Entity Type | Individual
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Provider Name | MAKENNA SALLADE
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Gender | Female
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Dates
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Enumeration Date | 09/03/2021
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 865 S WATSON RD STE 118
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City | BUCKEYE
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State | AZ
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Zip | 85326-3468
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Country | US
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Telephone | 623-212-1040
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Fax | 623-212-1041
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Provider Business Mailing Address
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Address Line | 14287 N 87TH ST STE 220
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-3698
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 10097
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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