Provider Demographics
NPI:1689129959
Name:ZUGELDER, DELANEY MABRY (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DELANEY
Middle Name:MABRY
Last Name:ZUGELDER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:DELANEY
Other - Middle Name:MARIE
Other - Last Name:MABRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27000 W LUGONIA AVE
Mailing Address - Street 2:APT 8211
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-2011
Mailing Address - Country:US
Mailing Address - Phone:512-230-8296
Mailing Address - Fax:
Practice Address - Street 1:27000 W LUGONIA AVE
Practice Address - Street 2:APT 8211
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-2011
Practice Address - Country:US
Practice Address - Phone:512-230-8296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23456235Z00000X
TX104387235Z00000X
OR015671235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist