Provider Demographics
NPI:1073181772
Name:BENDER, OLIVIA H (AUD)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:H
Last Name:BENDER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4530 E SHEA BLVD STE 180
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-6042
Mailing Address - Country:US
Mailing Address - Phone:602-264-4834
Mailing Address - Fax:
Practice Address - Street 1:1520 S DOBSON RD STE 217
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4754
Practice Address - Country:US
Practice Address - Phone:480-539-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-17
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA12506231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist