1033464722 NPI number — KAYLEE ELISABETH WALKER SLP-CF

Table of content: MRS. ANGELA THERESA GARDNER PT, DPT (NPI 1235432022)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033464722 NPI number — KAYLEE ELISABETH WALKER SLP-CF

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WALKER
Provider First Name:
KAYLEE
Provider Middle Name:
ELISABETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
SLP-CF
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033464722
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2728 CIRCLE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTA CLARA
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84765-5710
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
435-669-7914
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16428 E KINGSTREE BLVD
Provider Second Line Business Practice Location Address:
STARS
Provider Business Practice Location Address City Name:
FOUNTAIN HILLS
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85268
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-837-4565
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/18/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  TSLP7833 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com