MEDICARE: COLLEEN M. HART MACCCSLP

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	SLP0188	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	463315	OTHER	AZ	AHCCCS
2	AZ0143390	OTHER	AZ	BLUE CROSS/BLUE SHIELD ID

General Provider Information

NPI Number	:	1720083009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLLEEN M. HART MACCCSLP

Provider Business Mailing Address
First Line	:	1031 W INDIAN HILLS PL
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85023-6278
Country	:	US
Telephone Number	:	602-243-8600
Fax Number	:

Provider Business Practice Location Address
First Line	:	1031 W INDIAN HILLS PL
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85023-6278
Country	:	US
Telephone Number	:	602-243-8600
Fax Number	:

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

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	07/08/2007

Similar Medicare Providers

1174729289 — THE GARDEN OF FEEDIN', INC.
Practice Location Address:

1031 W INDIAN HILLS PL
PHOENIX, AZ
85023-6278

Practice Phone: 602-412-3736
Practice Fax:

1851696272 — RICHARD H DALEY, MD,PC
Practice Location Address:

6278 N 31ST WAY
PHOENIX, AZ
85016-2327

Practice Phone: 602-955-6642
Practice Fax:

1255173019 — WILLIAM TANNER DANIELL
Practice Location Address:

18444 N 25TH AVE STE 210
PHOENIX, AZ
85023-1264

Practice Phone: 866-974-2673
Practice Fax: 866-939-2673

1467316752 — KRISTEN ZARZAUR DPT
Practice Location Address:

320 W BELL RD STE 103
PHOENIX, AZ
85023-3511

Practice Phone: 602-767-6690
Practice Fax:

1215441837 — NICHOLAS P RAMIREZ DPT
Practice Location Address:

18444 N 25TH AVE STE 220
PHOENIX, AZ
85023-1264

Practice Phone: 866-974-2673
Practice Fax: 866-939-2673

1508729500 — KRISTIN RIGGS WYBLE-MEZA DPT
Practice Location Address:

18444 N 25TH AVE STE 310
PHOENIX, AZ
85023-1266

Practice Phone: 866-974-2673
Practice Fax: 866-939-2673

Directions to “ COLLEEN M. HART MACCCSLP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.