Provider Demographics
NPI:1821749490
Name:ZIOGAS, ATHENA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ATHENA
Middle Name:
Last Name:ZIOGAS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 PLEASANT ST APT 224
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-3166
Mailing Address - Country:US
Mailing Address - Phone:508-271-5827
Mailing Address - Fax:
Practice Address - Street 1:820 TURNPIKE ST STE 104
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-6125
Practice Address - Country:US
Practice Address - Phone:978-681-6605
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
MA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist