Healthcare Provider Details

I. General information

NPI: 1053527671
Provider Name (Legal Business Name): ZIMMERMAN SPEECH THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 08/27/2020
Certification Date: 08/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 S MCCLINTOCK DR STE 135
TEMPE AZ
85282-7375
US

IV. Provider business mailing address

2340 E NORA ST
MESA AZ
85213-1572
US

V. Phone/Fax

Practice location:
  • Phone: 602-919-2068
  • Fax:
Mailing address:
  • Phone: 602-919-2068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: CARLA ZIMMERMAN
Title or Position: PRESIDENT
Credential: M.N.S., CCC-SLP
Phone: 602-919-2068