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General NPI Number Information
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NPI Number | 1932315348
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Entity Type | Organization
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Legal Business Name | AMAZING ABILITIES THERAPIES
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8924 N 104TH AVE
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City | PEORIA
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State | AZ
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Zip | 85345-7306
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Country | US
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Telephone | 623-875-0419
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Fax | 623-388-3242
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Provider Business Mailing Address
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Address Line | 8924 N 104TH AVE
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City | PEORIA
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State | AZ
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Zip | 85345-7306
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Country | US
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Telephone | 623-875-0419
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Fax | 623-388-3242
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | MS. CYNTHIA ANN BLAIR
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Credential | M.S. CCC-SLP
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Telephone | 623-875-0419
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | SLP1493
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License Number State | AZ
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