Provider Demographics
NPI:1104328491
Name:CATALYST SPEECH THERAPY & DIAGNOSTICS LLC
Entity type:Organization
Organization Name:CATALYST SPEECH THERAPY & DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHAROLETTE
Authorized Official - Middle Name:E
Authorized Official - Last Name:VALDIZAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-363-1533
Mailing Address - Street 1:18213 N SKYHAWK DRIVE
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374
Mailing Address - Country:US
Mailing Address - Phone:623-363-1533
Mailing Address - Fax:623-328-9855
Practice Address - Street 1:18213 N SKYHAWK DRIVE
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374
Practice Address - Country:US
Practice Address - Phone:623-363-1533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATALYST SPEECH THERAPY & DIAGNOSTICS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-02
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP6845235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty