Provider Demographics
NPI:1598147944
Name:DE PAULA, ELIANITA SILVA (SLPA)
Entity Type:Individual
Prefix:
First Name:ELIANITA
Middle Name:SILVA
Last Name:DE PAULA
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 1:18330 N 79TH AVE
Mailing Address - Street 2:APT 1022
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-8343
Mailing Address - Country:US
Mailing Address - Phone:623-210-1080
Mailing Address - Fax:
Practice Address - Street 1:6991 E CAMELBACK RD
Practice Address - Street 2:SUITE D-300 SUITE 4
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-2432
Practice Address - Country:US
Practice Address - Phone:623-210-1080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA94482355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant