Provider Demographics
NPI:1346593142
Name:HUYNH, DAO THI (SLPA)
Entity Type:Individual
Prefix:MRS
First Name:DAO
Middle Name:THI
Last Name:HUYNH
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12893 N 57TH AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85304-1869
Mailing Address - Country:US
Mailing Address - Phone:602-750-9022
Mailing Address - Fax:
Practice Address - Street 1:12893 N 57TH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85304-1869
Practice Address - Country:US
Practice Address - Phone:602-750-9022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA8042235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist