Provider Demographics
NPI:1760518559
Name:DANZIGER, KYLA MICHELLE
Entity Type:Individual
Prefix:
First Name:KYLA
Middle Name:MICHELLE
Last Name:DANZIGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5844 E LE MARCHE AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-1863
Mailing Address - Country:US
Mailing Address - Phone:602-765-0150
Mailing Address - Fax:
Practice Address - Street 1:2040 S ALMA SCHOOL RD STE 1
Practice Address - Street 2:PMB 500
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-2076
Practice Address - Country:US
Practice Address - Phone:602-373-3136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP5227235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist