Provider Demographics
NPI:1114081130
Name:DAY, DANA L (AUD, CCC-A)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:L
Last Name:DAY
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4004 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-4701
Mailing Address - Country:US
Mailing Address - Phone:602-265-9000
Mailing Address - Fax:602-528-1901
Practice Address - Street 1:4004 N 7TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-4701
Practice Address - Country:US
Practice Address - Phone:602-265-9000
Practice Address - Fax:602-528-1901
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA747231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ835837OtherAHCCCS
AZQ08309Medicare UPIN
AZ78002Medicare ID - Type Unspecified