Provider Demographics
NPI:1932113727
Name:ZIGMAN, CARRIE LEE (SLP)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:LEE
Last Name:ZIGMAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:LEE
Other - Last Name:KOSOSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:1001 PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:NIAGARA
Mailing Address - State:WI
Mailing Address - Zip Code:54151-1145
Mailing Address - Country:US
Mailing Address - Phone:715-251-1598
Mailing Address - Fax:
Practice Address - Street 1:1074 PYLE DR
Practice Address - Street 2:
Practice Address - City:KINGSFORD
Practice Address - State:MI
Practice Address - Zip Code:49802-4451
Practice Address - Country:US
Practice Address - Phone:906-779-2692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI01045700235Z00000X
WI1246-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist