MEDICARE: MACKENZIE RAE ZEMOJTEL SLPA

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	2355S0801X	Speech-Language Assistant	SLPA17310	AZ

General Provider Information

NPI Number	:	1518899509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACKENZIE RAE ZEMOJTEL SLPA

Provider Business Mailing Address
First Line	:	2931 INDIAN SPRINGS DR
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86406-8516
Country	:	US
Telephone Number	:	928-854-5439
Fax Number	:	928-854-5440

Provider Business Practice Location Address
First Line	:	2931 INDIAN SPRINGS DR
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86406-8516
Country	:	US
Telephone Number	:	928-854-5439
Fax Number	:	928-854-5440

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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Directions to “ MACKENZIE RAE ZEMOJTEL SLPA” Practice Location

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