MEDICARE: JO & WILLIES VOW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	101YM0800X	Mental Health Counselor
4	101YP2500X	Professional Counselor
5	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1013696913
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JO & WILLIES VOW

Provider Business Mailing Address
First Line	:	PO BOX 85616
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85754-5616
Country	:	US
Telephone Number	:	800-856-0744
Fax Number	:

Provider Business Practice Location Address
First Line	:	1223 N 1ST AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85719-4002
Country	:	US
Telephone Number	:	800-856-0744
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	ALISSA MICHELLE ZETLMAIER
Credential	:
Telephone Number	:	909-744-2342

Provider Enumeration Date	:	07/17/2023
Last Update Date	:	07/17/2023

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Directions to “JO & WILLIES VOW ” Practice Location

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