Provider Demographics
NPI:1710152889
Name:ZILLICH, COLLEEN HANNIGAN (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:HANNIGAN
Last Name:ZILLICH
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7623 PINESPRINGS WEST DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-4022
Mailing Address - Country:US
Mailing Address - Phone:317-258-0863
Mailing Address - Fax:
Practice Address - Street 1:7623 PINESPRINGS WEST DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-4022
Practice Address - Country:US
Practice Address - Phone:317-258-0863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003871A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist