MEDICARE: JESSICA N ZON M.A. CCC-SLP

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	235Z00000X	Speech-Language Pathologist		CO

General Provider Information

NPI Number	:	1689131963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA N ZON M.A. CCC-SLP

Provider Business Mailing Address
First Line	:	2770 S FRANKLIN ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80210-5909
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2770 S FRANKLIN ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80210-5909
Country	:	US
Telephone Number	:	720-891-1433
Fax Number	:

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

Provider Enumeration Date	:	02/22/2019
Last Update Date	:	02/22/2019

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Language	Start Address	Practice Location

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