Provider Demographics
NPI:1912729872
Name:FIELD PEDIATRIC SPEECH THERAPY PLLC
Entity type:Organization
Organization Name:FIELD PEDIATRIC SPEECH THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:480-206-6553
Mailing Address - Street 1:11120 E VILLA PARK ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-7817
Mailing Address - Country:US
Mailing Address - Phone:480-206-6553
Mailing Address - Fax:
Practice Address - Street 1:2111 E BASELINE RD STE F5
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1519
Practice Address - Country:US
Practice Address - Phone:602-834-3999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty