Provider Demographics
NPI:1487918157
Name:ZEPEDA, GUISSELLE A (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:GUISSELLE
Middle Name:A
Last Name:ZEPEDA
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 1:12316 SW 10TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-2445
Mailing Address - Country:US
Mailing Address - Phone:305-725-2511
Mailing Address - Fax:
Practice Address - Street 1:12316 SW 10TH LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-2445
Practice Address - Country:US
Practice Address - Phone:305-725-2511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 8301235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist