Provider Demographics
NPI:1467689083
Name:SPEECH AND COGNITION CENTER
Entity Type:Organization
Organization Name:SPEECH AND COGNITION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH AND LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:ELEANOR
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-451-8043
Mailing Address - Street 1:4545 E SHEA BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-3076
Mailing Address - Country:US
Mailing Address - Phone:602-451-8043
Mailing Address - Fax:602-494-0793
Practice Address - Street 1:4545 E SHEA BLVD STE 203
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-3076
Practice Address - Country:US
Practice Address - Phone:602-451-8043
Practice Address - Fax:602-494-0793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-22
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP-0459235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty