Healthcare Provider Details

I. General information

NPI: 1962240630
Provider Name (Legal Business Name): KRISTEN ANN ZOLLARS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRISTEN ZOLLARS LPC

II. Dates (important events)

Enumeration Date: 07/17/2024
Last Update Date: 07/17/2024
Certification Date: 07/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 S MCCLINTOCK DR STE 101
TEMPE AZ
85282-2691
US

IV. Provider business mailing address

2020 S MCCLINTOCK DR STE 101
TEMPE AZ
85282-2691
US

V. Phone/Fax

Practice location:
  • Phone: 480-579-8827
  • Fax:
Mailing address:
  • Phone: 480-579-8827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-14078
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: