Healthcare Provider Details

I. General information

NPI: 1861087041
Provider Name (Legal Business Name): ZOLA WELLNESS SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2021
Last Update Date: 03/09/2021
Certification Date: 03/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1287 CHAPEL ST
NEW HAVEN CT
06511-4514
US

IV. Provider business mailing address

1287 CHAPEL ST
NEW HAVEN CT
06511-4514
US

V. Phone/Fax

Practice location:
  • Phone: 203-624-4477
  • Fax: 203-848-3096
Mailing address:
  • Phone: 203-624-4477
  • Fax: 203-848-3096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARISSA T. SPENCER
Title or Position: ADMINISTRATIVE ASSISTANT
Credential:
Phone: 203-507-9106