Provider Demographics
NPI:1962845701
Name:FISSEL, SCHEA (PHD, CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:SCHEA
Middle Name:
Last Name:FISSEL
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19555 N. 59TH AVE.
Mailing Address - Street 2:CACTUS WREN HALL 302-H
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-6813
Mailing Address - Country:US
Mailing Address - Phone:623-537-6326
Mailing Address - Fax:
Practice Address - Street 1:19555 N. 59TH AVE.
Practice Address - Street 2:CACTUS WREN HALL 302-H
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-6813
Practice Address - Country:US
Practice Address - Phone:623-537-6326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-11
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH12142494235Z00000X
AZSLP9886235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist