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NPI Code Detail

MEDICARE: JOHANNA MARIE ZELLARS

MEDICARE:   JOHANNA MARIE ZELLARS
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
1103K00000XBehavior AnalystMA

General Provider Information

NPI Number : 1467084517
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHANNA MARIE ZELLARS
Provider Business Mailing Address
First Line : 4 FRANCES HELEN RD
Second Line :
City : YARMOUTH PORT
State : MA
Zip : 02675-2403
Country : US
Telephone Number : 774-368-2602
Fax Number :
Provider Business Practice Location Address
First Line : 4 FRANCES HELEN RD
Second Line :
City : YARMOUTH PORT
State : MA
Zip : 02675-2403
Country : US
Telephone Number : 774-368-2602
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2020
Last Update Date : 02/06/2020

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Directions to “ JOHANNA MARIE ZELLARS ” Practice Location

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