MEDICARE: KATHY DANIELS BALZANO LLC

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

General Provider Information

NPI Number	:	1679405393
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KATHY DANIELS BALZANO LLC

Provider Business Mailing Address
First Line	:	1717 W STATE AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85021-7955
Country	:	US
Telephone Number	:	602-525-1244
Fax Number	:

Provider Business Practice Location Address
First Line	:	1717 W STATE AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85021-7955
Country	:	US
Telephone Number	:	602-525-1244
Fax Number	:

Authorized Official
Title or Position	:	SPEECH LANGUAGE PATHOLOGIST
Name	:	KATHY DANIELS BALZANO
Credential	:	CCC-SLP
Telephone Number	:	602-525-1244

Provider Enumeration Date	:	05/29/2026
Last Update Date	:	05/29/2026

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Directions to “KATHY DANIELS BALZANO LLC ” Practice Location

Language	Start Address	Practice Location

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