Provider Demographics
NPI:1053527671
Name:ZIMMERMAN SPEECH THERAPY, INC.
Entity type:Organization
Organization Name:ZIMMERMAN SPEECH THERAPY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MNS, CCC-SLP
Authorized Official - Phone:602-919-2068
Mailing Address - Street 1:2340 E NORA ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-1572
Mailing Address - Country:US
Mailing Address - Phone:602-919-2068
Mailing Address - Fax:
Practice Address - Street 1:4700 S MCCLINTOCK DR STE 135
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7375
Practice Address - Country:US
Practice Address - Phone:602-919-2068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and SpeechGroup - Single Specialty