Provider Demographics
NPI:1497086961
Name:MERIDETH-ZANTOUT, DEBBIE MICHELE (MT-BC, SLP-A)
Entity Type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:MICHELE
Last Name:MERIDETH-ZANTOUT
Suffix:
Gender:F
Credentials:MT-BC, SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 S TACOMA
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-3749
Mailing Address - Country:US
Mailing Address - Phone:480-650-9959
Mailing Address - Fax:
Practice Address - Street 1:22719 S ELLSWORTH RD
Practice Address - Street 2:BUILDING C, SUITE 103
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-6128
Practice Address - Country:US
Practice Address - Phone:480-612-0395
Practice Address - Fax:480-659-9044
Is Sole Proprietor?:No
Enumeration Date:2010-01-24
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ06236225A00000X
AZSLPA95302355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant