Provider Demographics
NPI:1780064493
Name:HALLER, ZSOFIA (SLP CCC)
Entity type:Individual
Prefix:MRS
First Name:ZSOFIA
Middle Name:
Last Name:HALLER
Suffix:
Gender:F
Credentials:SLP CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6100 ALCOTT ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-3702
Mailing Address - Country:US
Mailing Address - Phone:424-230-4177
Mailing Address - Fax:
Practice Address - Street 1:6100 ALCOTT ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-3702
Practice Address - Country:US
Practice Address - Phone:424-230-4177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDCCC-SLP 14101276235Z00000X
CASP 22361235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist