Provider Demographics
NPI:1164304168
Name:DOULAH, FARAH N
Entity type:Individual
Prefix:
First Name:FARAH
Middle Name:N
Last Name:DOULAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 E MELROSE ST APT 2116
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-8011
Mailing Address - Country:US
Mailing Address - Phone:480-457-0397
Mailing Address - Fax:
Practice Address - Street 1:7776 S POINTE PKWY W STE 250
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-5428
Practice Address - Country:US
Practice Address - Phone:480-518-7073
Practice Address - Fax:480-564-5775
Is Sole Proprietor?:No
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP16527235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist