Provider Demographics
NPI:1124749247
Name:DUNLAP, AUBREY TAYLOR (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:TAYLOR
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:AUBREY
Other - Middle Name:TAYLOR
Other - Last Name:KLINGENSMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:1118 E MANHATTON DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-5524
Mailing Address - Country:US
Mailing Address - Phone:585-698-0271
Mailing Address - Fax:
Practice Address - Street 1:19555 N 59TH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-6813
Practice Address - Country:US
Practice Address - Phone:623-537-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
14040216OtherAMERICAN SPEECH LANGUAGE HEARING ASSOCIATION
AZSLP8674OtherSPEECH LANGUAGE PATHOLOGY LICENSE