Healthcare Provider Details

I. General information

NPI: 1134187917
Provider Name (Legal Business Name): CYNTHIA GAY ZOLLMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 10/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30838 VINES CREEK RD UNIT 2C
DAGSBORO DE
19939-4385
US

IV. Provider business mailing address

10054 IRON POINTE DRIVE EXT
MILLSBORO DE
19966-4268
US

V. Phone/Fax

Practice location:
  • Phone: 717-538-5170
  • Fax:
Mailing address:
  • Phone: 717-538-5170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW012695
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: