Fiesta Pediatric Therapy

NPI #1255711131 in Phoenix, Arizona

Provider Information

NPI Number
1255711131
Entity Type
Organization
Organization Name
Fiesta Pediatric Therapy
Primary Specialty
Early Intervention Provider Agency
Enumeration Date
Jun 4, 2015
Last Updated
Jun 4, 2015

Practice Location

Address
2302 N 15TH AVE
State
Arizona
ZIP Code
85007-1201
Phone
(602) 396-4374

Authorized Official

Name
MISS VANESSA GAISER, CCC-SLP
Title
SPEECH LANGUAGE PATHOLOGIST
Phone
(602) 396-4374

Specialties & Taxonomy Codes

Specialty
Early Intervention Provider Agency

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