Healthcare Provider Details

I. General information

NPI: 1790675221
Provider Name (Legal Business Name): KATIE ZIRZOW MS, SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2025
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2335 S GREEN BAY RD
RACINE WI
53406-4921
US

IV. Provider business mailing address

2335 S GREEN BAY RD
RACINE WI
53406-4921
US

V. Phone/Fax

Practice location:
  • Phone: 262-497-7270
  • Fax: 877-540-0135
Mailing address:
  • Phone: 262-497-7270
  • Fax: 877-540-0135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7004-154
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: