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General NPI Number Information
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NPI Number | 1487370763
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Entity Type | Individual
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Provider Name | ESTEBAN ZERMENO SLPA
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Gender | Male
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Dates
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Enumeration Date | 10/18/2022
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Last Update Date | 10/18/2022
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Provider Practice Location Address
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Address Line | 1494 S CONGRESS AVE
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City | SOMERTON
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State | AZ
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Zip | 85350-8535
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Country | US
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Telephone | 928-750-3980
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3674
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City | SOMERTON
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State | AZ
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Zip | 85350-3674
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Country | US
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Telephone | 928-750-3980
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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 | SLPA12881
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License Number State | AZ
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