Healthcare Provider Details

I. General information

NPI: 1578198537
Provider Name (Legal Business Name): ZAKIYA PASLEY ITDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2020
Last Update Date: 05/08/2022
Certification Date: 05/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 HAWTHORNE HILLS PL APT 101
ORLANDO FL
32835-6867
US

IV. Provider business mailing address

314 HAWTHORNE HILLS PL APT 101
ORLANDO FL
32835-6867
US

V. Phone/Fax

Practice location:
  • Phone: 786-357-0858
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: