Healthcare Provider Details

I. General information

NPI: 1831217686
Provider Name (Legal Business Name): JULIA ZAPADKA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2235 E 25TH ST STE 290
IDAHO FALLS ID
83404-7595
US

IV. Provider business mailing address

PO BOX 3480
IDAHO FALLS ID
83403-3480
US

V. Phone/Fax

Practice location:
  • Phone: 208-552-0490
  • Fax: 208-552-2518
Mailing address:
  • Phone: 208-552-0490
  • Fax: 208-552-2518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: