Organization
NK SPEECH THERAPY AND BEHAVIOR SUPPORT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE KAVANAGH CCC-SLP (OWNER)
(480) 518-7073
Entity
Organization
Contact information
Practice address
7776 S POINTE PKWY W STE 250, PHOENIX, AZ 85044-5428
(480) 518-7073
Mailing address
5783 S FAWN AVE, GILBERT, AZ 85298-0848
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QH0700X
Hearing and Speech Clinic/Center
Primary
—
—
Other
Enumeration date
05/02/2022
Last updated
10/12/2022
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