Provider Demographics
NPI:1720160989
Name:ZOLLINGER, ELIZABETH MAYCOCK (AUD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:MAYCOCK
Last Name:ZOLLINGER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1257
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-1257
Mailing Address - Country:US
Mailing Address - Phone:912-660-1683
Mailing Address - Fax:912-920-4262
Practice Address - Street 1:10 CHADWICK CT
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-8274
Practice Address - Country:US
Practice Address - Phone:912-660-1683
Practice Address - Fax:912-920-4262
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003691231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist