MEDICARE: ZIMMERMAN SPEECH THERAPY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0700X	Hearing and Speech Clinic/Center
2	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1053527671
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZIMMERMAN SPEECH THERAPY, INC.

Provider Business Mailing Address
First Line	:	2340 E NORA ST
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85213-1572
Country	:	US
Telephone Number	:	602-919-2068
Fax Number	:

Provider Business Practice Location Address
First Line	:	4700 S MCCLINTOCK DR STE 135
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-7375
Country	:	US
Telephone Number	:	602-919-2068
Fax Number	:

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

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	08/27/2020

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