Provider Demographics
NPI:1073747978
Name:PEDIATRIC SPEECH & LANGUAGE SPECIALISTS
Entity Type:Organization
Organization Name:PEDIATRIC SPEECH & LANGUAGE SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:WERNER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:480-991-6560
Mailing Address - Street 1:6865 E BECKER LN
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-6730
Mailing Address - Country:US
Mailing Address - Phone:480-991-6560
Mailing Address - Fax:480-607-9246
Practice Address - Street 1:6865 E BECKER LN
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-6730
Practice Address - Country:US
Practice Address - Phone:480-991-6560
Practice Address - Fax:480-607-9246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP0490235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty