Provider Demographics
NPI:1225268063
Name:ZITTEL, TRACEY (SLP)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:
Last Name:ZITTEL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4045 E UNION HILLS DR STE 110
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-3389
Mailing Address - Country:US
Mailing Address - Phone:602-595-0074
Mailing Address - Fax:480-451-7780
Practice Address - Street 1:4045 E UNION HILLS DR STE 110
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050
Practice Address - Country:US
Practice Address - Phone:602-595-0074
Practice Address - Fax:480-451-7780
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist