Provider Demographics
NPI:1609095991
Name:DYKINGA THERAPY SERVICES, L.L.C
Entity Type:Organization
Organization Name:DYKINGA THERAPY SERVICES, L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DYKINGA
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:520-237-2850
Mailing Address - Street 1:12316 N CLOUD RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85755-6560
Mailing Address - Country:US
Mailing Address - Phone:520-237-2850
Mailing Address - Fax:520-743-0277
Practice Address - Street 1:12316 N CLOUD RIDGE DR
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-6560
Practice Address - Country:US
Practice Address - Phone:520-237-2850
Practice Address - Fax:520-743-0277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZSLP1856235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty