MEDICARE: MRS. SAMANTHIA Z ZOLNOSKI M.A.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist

General Provider Information

NPI Number	:	1194098293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SAMANTHIA Z ZOLNOSKI M.A.

Provider Business Mailing Address
First Line	:	38746 PLAINVIEW DR
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48312-1443
Country	:	US
Telephone Number	:	586-871-4957
Fax Number	:

Provider Business Practice Location Address
First Line	:	38746 PLAINVIEW DR
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48312-1443
Country	:	US
Telephone Number	:	586-871-4957
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2012
Last Update Date	:	02/21/2012

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