Bryan Acosta, M.S., CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Glendale, AZ
NPI 1558039461 · NPPES record last updated Sep 3, 2021
Key facts
- NPI
- 1558039461
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SLP12521 (AZ)
- Practice address
- 7650 N 43Rd Ave
Glendale, AZ 85301-1661 - Phone
- (623) 435-6000
- NPI assigned
- Sep 3, 2021
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP12521 | AZ | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Glendale Union High School Dist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist |
235Z00000X | SLP12521 | AZ | Yes |
Addresses
Primary practice location
7650 N 43Rd Ave
Glendale, AZ 85301-1661
Mailing address
624 W Indianola Ave Unit 115
Phoenix, AZ 85013-3370
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All providers in Glendale, AZ · Speech-Language Pathologist in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.