Provider Demographics
NPI:1245099035
Name:HEYLIGER MERISME, ZOYA
Entity type:Individual
Prefix:
First Name:ZOYA
Middle Name:
Last Name:HEYLIGER MERISME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ZOYA
Other - Middle Name:
Other - Last Name:MERISME
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:411 WEST DUFFY STREET
Mailing Address - Street 2:CARRIAGE HOUSE/CH
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-6716
Mailing Address - Country:US
Mailing Address - Phone:678-863-2477
Mailing Address - Fax:
Practice Address - Street 1:2699 STIRLING ROAD
Practice Address - Street 2:SUITE 302-C
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312
Practice Address - Country:US
Practice Address - Phone:954-820-7402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-15
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL016884235Z00000X
GASLP011524235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist