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General NPI Number Information
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NPI Number | 1801202031
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Entity Type | Organization
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Legal Business Name | ARIZONA THERAPY SQUAD, LLC
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Dates
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Enumeration Date | 07/08/2014
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Last Update Date | 07/08/2014
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Provider Practice Location Address
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Address Line | 4410 W UNION HILLS DR STE 7-272
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City | GLENDALE
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State | AZ
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Zip | 85308-1660
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Country | US
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Telephone | 928-607-0441
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Fax | 602-926-8252
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Provider Business Mailing Address
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Address Line | 4410 W UNION HILLS DR STE 7-272
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City | GLENDALE
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State | AZ
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Zip | 85308-1660
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Country | US
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Telephone | 928-607-0441
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Fax | 602-926-8252
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Authorized Official
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Title or Position | OWNER/SPEECH-LANGUAGE PATHOLOGIST
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Name | MRS. STEPHANIE LEIGH STROM
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Credential | CCC-SLP
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Telephone | 928-607-0441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | SLP7638
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License Number State | AZ
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