Provider Demographics
NPI:1568771863
Name:BEROLZHEIMER, JEAN (MS, CCC)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:
Last Name:BEROLZHEIMER
Suffix:
Gender:F
Credentials:MS, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 819
Mailing Address - Street 2:
Mailing Address - City:ORTING
Mailing Address - State:WA
Mailing Address - Zip Code:98360-0819
Mailing Address - Country:US
Mailing Address - Phone:888-698-6488
Mailing Address - Fax:
Practice Address - Street 1:2205 N 45TH ST UNIT A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-6903
Practice Address - Country:US
Practice Address - Phone:206-547-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist