Healthcare Provider Details

I. General information

NPI: 1770476939
Provider Name (Legal Business Name): MADISON ANN ZWANZIGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2025
Last Update Date: 05/29/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3715 W 133RD ST
LEAWOOD KS
66209-3347
US

IV. Provider business mailing address

13311 BRADSHAW ST APT 7109
OVERLAND PARK KS
66213-4977
US

V. Phone/Fax

Practice location:
  • Phone: 913-213-3531
  • Fax:
Mailing address:
  • Phone: 641-425-4086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: