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NPI Code Detail

MEDICARE: AMANDA ZASTROW ED.S, NCSP

MEDICARE: AMANDA ZASTROW ED.S, NCSP
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
1103TS0200XSchool Psychologist756250WI

General Provider Information

NPI Number : 1891627410
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA ZASTROW ED.S, NCSP
Provider Business Mailing Address
First Line : 1900 POLK ST
Second Line :
City : STEVENS POINT
State : WI
Zip : 54481-5875
Country : US
Telephone Number : 715-345-5612
Fax Number :
Provider Business Practice Location Address
First Line : 1900 POLK ST
Second Line :
City : STEVENS POINT
State : WI
Zip : 54481-5875
Country : US
Telephone Number : 715-345-5612
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2026
Last Update Date : 05/29/2026

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