Provider Demographics
NPI:1205944030
Name:EAST VALLEY SPEECH PATHOLOGY ASSOC LLC
Entity type:Organization
Organization Name:EAST VALLEY SPEECH PATHOLOGY ASSOC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER SPEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CALL
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCCSP
Authorized Official - Phone:480-820-6366
Mailing Address - Street 1:PO BOX 6397
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85246
Mailing Address - Country:US
Mailing Address - Phone:480-820-6366
Mailing Address - Fax:480-820-0462
Practice Address - Street 1:2220 S COUNTRY CLUB
Practice Address - Street 2:#104
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210
Practice Address - Country:US
Practice Address - Phone:480-820-6366
Practice Address - Fax:480-820-0462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech