Provider Demographics
NPI:1295386696
Name:TRAMBULO, TAYLOR (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:TRAMBULO
Suffix:
Gender:
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:
Other - Last Name:WESTPHAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:445 W CHANDLER BLVD APT 460
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-1965
Mailing Address - Country:US
Mailing Address - Phone:253-282-7892
Mailing Address - Fax:
Practice Address - Street 1:3941 E BASELINE RD STE 101
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2750
Practice Address - Country:US
Practice Address - Phone:480-787-5387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-26
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program