Provider Demographics
NPI:1528209830
Name:DESERT VALLEY PEDIATRIC THERAPY
Entity Type:Organization
Organization Name:DESERT VALLEY PEDIATRIC THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SORRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:480-704-5954
Mailing Address - Street 1:4350 E RAY RD STE 101A
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-4707
Mailing Address - Country:US
Mailing Address - Phone:480-704-5954
Mailing Address - Fax:480-704-5807
Practice Address - Street 1:4350 E RAY RD STE 101A
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-4707
Practice Address - Country:US
Practice Address - Phone:480-704-5954
Practice Address - Fax:480-704-5807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-16
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty