Active NPI
Kendall Boulay
- Speech-Language Assistant
- Peoria, AZ
National Provider Identifier
1356024079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- SLPA14516
- Practice address
- 31501 N Westland Rd
Peoria, AZ 85383-7846 - Phone
- (623) 773-6575
- NPI assigned
- Aug 9, 2023
- Last updated
- Aug 9, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | SLPA14516 | AZ | Primary |
Addresses
Primary practice location
31501 N Westland Rd
Peoria, AZ 85383-7846
Mailing address
23720 N 79TH Ave
Peoria, AZ 85383-5613
Phone (623) 826-2203
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLPA14516 | AZ | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691539200000",
"number": "1356024079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23720 N 79TH AVE",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853835613",
"telephone_number": "623-826-2203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31501 N WESTLAND RD",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853837846",
"telephone_number": "623-773-6575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOULAY",
"first_name": "KENDALL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-09",
"last_updated": "2023-08-09",
"certification_date": "2023-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "AZ",
"license": "SLPA14516",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.