Provider Demographics
NPI:1649599895
Name:ZANDARSKI, NICOLE (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:ZANDARSKI
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SPRING ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49283-9647
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:151 2ND ST
Practice Address - Street 2:
Practice Address - City:SPRING ARBOR
Practice Address - State:MI
Practice Address - Zip Code:49283-9647
Practice Address - Country:US
Practice Address - Phone:517-750-1900
Practice Address - Fax:517-750-3742
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-27
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist