MEDICARE: ANNA-ALYSE TELLEZ M.S., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SLP8984	AZ
2	235Z00000X	Speech-Language Pathologist	TSA8984	AZ

General Provider Information

NPI Number	:	1013305549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA-ALYSE TELLEZ M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	3336 E TULSA ST
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85295-3418
Country	:	US
Telephone Number	:	520-405-6184
Fax Number	:

Provider Business Practice Location Address
First Line	:	4100 S LINDSAY RD STE 113
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85297-1507
Country	:	US
Telephone Number	:	480-219-3953
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2015
Last Update Date	:	04/13/2026

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