Provider Demographics
NPI:1922154210
Name:ZILLER, GEORGIA J (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:GEORGIA
Middle Name:J
Last Name:ZILLER
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 1:6509 N CYPRESS AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64119-5303
Mailing Address - Country:US
Mailing Address - Phone:816-590-6813
Mailing Address - Fax:
Practice Address - Street 1:6509 N CYPRESS AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64119-5303
Practice Address - Country:US
Practice Address - Phone:816-590-6813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00922235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist