Healthcare Provider Details

I. General information

NPI: 1376788570
Provider Name (Legal Business Name): SLAVOMIR LEON ZAPATA PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2008
Last Update Date: 12/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 IRVING ST NW
WASHINGTON DC
20422-0001
US

IV. Provider business mailing address

50 IRVING ST NW
WASHINGTON DC
20422-0001
US

V. Phone/Fax

Practice location:
  • Phone: 202-745-8000
  • Fax: 202-745-8169
Mailing address:
  • Phone: 202-745-8000
  • Fax: 202-745-8169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810004035
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: