Organization
ABUNDANT LIFE THERAPY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHANIKKA PERRYMAN (OWNER/DIRECTOR)
(602) 614-5584
Entity
Organization
Contact information
Practice address
7836 W MCLELLAN RD, GLENDALE, AZ 85303-3405
(602) 428-1617
(602) 636-2575
Mailing address
7836 W MCLELLAN RD, GLENDALE, AZ 85303-3405
(602) 428-1617
(602) 636-2575
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
06/19/2017
Last updated
07/21/2022
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