Provider Demographics
NPI:1427606516
Name:ZETTLEMOYER, MERCEDES (MS, CCC-SLP, TSSLD)
Entity Type:Individual
Prefix:MS
First Name:MERCEDES
Middle Name:
Last Name:ZETTLEMOYER
Suffix:
Gender:F
Credentials:MS, CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2776 S ARLINGTON MILL DR # 534
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-3402
Mailing Address - Country:US
Mailing Address - Phone:703-879-2479
Mailing Address - Fax:703-879-2803
Practice Address - Street 1:6715 LITTLE RIVER TURNPIKE
Practice Address - Street 2:SUITE 200
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3565
Practice Address - Country:US
Practice Address - Phone:703-879-2479
Practice Address - Fax:703-879-2803
Is Sole Proprietor?:No
Enumeration Date:2019-08-31
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202009977235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist