Provider Demographics
NPI:1598416257
Name:WALLS, ZOE SAYRE (MS CFY-SLP)
Entity Type:Individual
Prefix:
First Name:ZOE
Middle Name:SAYRE
Last Name:WALLS
Suffix:
Gender:F
Credentials:MS CFY-SLP
Other - Prefix:
Other - First Name:ZOE
Other - Middle Name:CROWELL
Other - Last Name:SAYRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:107 ALFRED RD
Mailing Address - Street 2:
Mailing Address - City:KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04043-6182
Mailing Address - Country:US
Mailing Address - Phone:973-727-0403
Mailing Address - Fax:
Practice Address - Street 1:3 BRAZIER LN
Practice Address - Street 2:
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-6938
Practice Address - Country:US
Practice Address - Phone:207-985-3030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEST3649235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist