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General NPI Number Information
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NPI Number | 1457681496
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Entity Type | Individual
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Provider Name | MRS. MARY EVELYN ZIEGLER
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Gender | Female
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Dates
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Enumeration Date | 01/13/2010
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Last Update Date | 01/13/2010
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Provider Practice Location Address
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Address Line | 17999 W SURPRISE FARMS LOOP S
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City | SURPRISE
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State | AZ
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Zip | 85388-6641
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Country | US
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Telephone | 623-876-7530
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Fax |
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Provider Business Mailing Address
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Address Line | 12326 W CHARTER OAK RD
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City | EL MIRAGE
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State | AZ
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Zip | 85335-5265
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Country | US
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Telephone | 602-677-7247
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | #SLPA6286
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License Number State | AZ
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