Provider Demographics
NPI:1902461312
Name:MIGHTY OAKS THERAPY PLLC
Entity Type:Organization
Organization Name:MIGHTY OAKS THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:RAKOZY
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:630-956-1080
Mailing Address - Street 1:26907 N 51ST DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85083-1279
Mailing Address - Country:US
Mailing Address - Phone:630-956-1080
Mailing Address - Fax:
Practice Address - Street 1:20329 N 59TH AVE STE A5
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-6854
Practice Address - Country:US
Practice Address - Phone:630-956-1080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-01
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational MedicineGroup - Multi-Specialty