MEDICARE: SAIRA MARIA OLIVAS SLPA

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	SLLPA10151	AZ

General Provider Information

NPI Number	:	1568915304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAIRA MARIA OLIVAS SLPA

Provider Business Mailing Address
First Line	:	6636 W COOLIDGE ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85033-1655
Country	:	US
Telephone Number	:	623-329-7616
Fax Number	:

Provider Business Practice Location Address
First Line	:	5314 N 7TH ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85014-2805
Country	:	US
Telephone Number	:	623-329-7616
Fax Number	:

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

Provider Enumeration Date	:	07/28/2016
Last Update Date	:	07/28/2016

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Directions to “ SAIRA MARIA OLIVAS SLPA” Practice Location

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