OrganizationActive
Intercept Speech and Language, LLC
NPI 1679656409 · Developmentally Disabled Services Day Training Agency · Sierra Vista, AZ
Provider details
- NPI number
- 1679656409
- Entity type
- Organization
- Primary specialty
- Developmentally Disabled Services Day Training AgencyAgencies
- Authorized official
- Corneta Kelley, Owner
- License
- SLP4673 (AZ)
Practice location
1201 E Fry Blvd
Suite #1
Sierra Vista, AZ 85635-2600
Phone: (520) 459-8258
Fax: (520) 459-8619
Mailing address
13428 Maxella Ave # 228
Marina Del Rey, CA 90292-5620
Registry dates
- Enumerated
- 2006-10-23
- Last updated
- 2009-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.