Individual
TRACY DIANE ZOLLTHEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
6855 W. MEADOWS LOOP EAST, LAVEEN, AZ 85339
(602) 304-2020
(602) 304-2025
Mailing address
6855 W. MEADOWS LOOP EAST, LAVEEN, AZ 85339
(602) 304-2020
(602) 304-2025
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP5053
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669650388
—
AZ
Enumeration date
03/29/2012
Last updated
03/29/2012
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