Provider Demographics
NPI:1154868198
Name:ZILZ, ALEXANDRIA (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:
Last Name:ZILZ
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 DARBY RD
Mailing Address - Street 2:
Mailing Address - City:HAVERFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19041-1061
Mailing Address - Country:US
Mailing Address - Phone:610-642-3000
Mailing Address - Fax:
Practice Address - Street 1:3300 DARBY RD
Practice Address - Street 2:
Practice Address - City:HAVERFORD
Practice Address - State:PA
Practice Address - Zip Code:19041-1061
Practice Address - Country:US
Practice Address - Phone:610-642-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-29
Last Update Date:2017-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL013296235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist