Provider Demographics
NPI:1548882897
Name:A TO ZEMAN SPEECH THERAPY
Entity type:Organization
Organization Name:A TO ZEMAN SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH AND LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:248-760-8242
Mailing Address - Street 1:7055 WHITE PINE DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48301-3716
Mailing Address - Country:US
Mailing Address - Phone:248-760-8242
Mailing Address - Fax:
Practice Address - Street 1:900 OAKWOOD ST
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-6229
Practice Address - Country:US
Practice Address - Phone:248-760-8242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-09
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7101004711OtherSTATE LICENSURE
MI13969529Medicaid
MI1093106610Medicaid