Provider Demographics
NPI:1578994760
Name:ZITTING, JEANNA LOUISE (SLPA)
Entity Type:Individual
Prefix:MS
First Name:JEANNA
Middle Name:LOUISE
Last Name:ZITTING
Suffix:
Gender:F
Credentials:SLPA
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 3391
Mailing Address - Street 2:
Mailing Address - City:COLORADO CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86021-3391
Mailing Address - Country:US
Mailing Address - Phone:435-467-0446
Mailing Address - Fax:
Practice Address - Street 1:255 NORTH COTTONWOOD STREET
Practice Address - Street 2:
Practice Address - City:COLORADO CITY
Practice Address - State:AZ
Practice Address - Zip Code:86021-3391
Practice Address - Country:US
Practice Address - Phone:928-875-9007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ#SLP84552355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant