MEDICARE: VANESSA MARIANNE ZEPEDA

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	14288996	TX
2	235Z00000X	Speech-Language Pathologist	117468	TX

General Provider Information

NPI Number	:	1962122382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA MARIANNE ZEPEDA

Provider Business Mailing Address
First Line	:	1319 ANNA PALM WAY
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-4045
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1319 ANNA PALM WAY
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-4045
Country	:	US
Telephone Number	:	361-249-6618
Fax Number	:

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

Provider Enumeration Date	:	08/29/2022
Last Update Date	:	08/29/2022

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Directions to “ VANESSA MARIANNE ZEPEDA ” Practice Location

Language	Start Address	Practice Location

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