Provider Demographics
NPI:1992176713
Name:KLEINDEL, ALISHA MARIE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ALISHA
Middle Name:MARIE
Last Name:KLEINDEL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19389 N 59TH AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-6500
Mailing Address - Country:US
Mailing Address - Phone:623-537-6000
Mailing Address - Fax:623-806-7689
Practice Address - Street 1:5815 W UTOPIA ROAD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308
Practice Address - Country:US
Practice Address - Phone:623-537-6000
Practice Address - Fax:623-806-7689
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL 60151632235Z00000X
AZSLP13644235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist