Provider Demographics
NPI:1639409196
Name:WITBECK, ERIK PRESTON
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:PRESTON
Last Name:WITBECK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9097 E. DESERT COVE
Mailing Address - Street 2:STE. 260
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260
Mailing Address - Country:US
Mailing Address - Phone:480-273-8500
Mailing Address - Fax:480-214-9937
Practice Address - Street 1:726 N GREENFIELD RD
Practice Address - Street 2:STE. 101
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-5061
Practice Address - Country:US
Practice Address - Phone:480-833-8620
Practice Address - Fax:480-833-8621
Is Sole Proprietor?:No
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA6472231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist