Healthcare Provider Details

I. General information

NPI: 1669148243
Provider Name (Legal Business Name): LISA ZAPPONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2021
Last Update Date: 10/27/2023
Certification Date: 10/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 BRANFORD RD UNIT 303
NORTH BRANFORD CT
06471-1371
US

IV. Provider business mailing address

416 HIGHLAND AVE
CHESHIRE CT
06410-2527
US

V. Phone/Fax

Practice location:
  • Phone: 203-217-5570
  • Fax:
Mailing address:
  • Phone: 203-217-5570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2663
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: