Provider Demographics
NPI:1184904005
Name:TECHNOLOGY ACCESS CENTER OF TUCSON, INC.
Entity type:Organization
Organization Name:TECHNOLOGY ACCESS CENTER OF TUCSON, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREASURER/BOARD OF DIRECTORS
Authorized Official - Prefix:MS
Authorized Official - First Name:MADELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:520-207-8988
Mailing Address - Street 1:5930 E PIMA ST.
Mailing Address - Street 2:SUITE 138
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712
Mailing Address - Country:US
Mailing Address - Phone:520-207-8988
Mailing Address - Fax:520-207-0041
Practice Address - Street 1:5930 E PIMA ST.
Practice Address - Street 2:SUITE 138
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712
Practice Address - Country:US
Practice Address - Phone:520-207-8988
Practice Address - Fax:520-207-0041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-23
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0361225XE1200X
AZSLP1027235Z00000X
AZ1900225XE1200X
AZ0519225XE1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomicsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty