Healthcare Provider Details

I. General information

NPI: 1891000618
Provider Name (Legal Business Name): VICKY ZANG LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2010
Last Update Date: 03/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12676 NATIONAL PIKE
GRANTSVILLE MD
21536-3320
US

IV. Provider business mailing address

12676 NATIONAL PIKE
GRANTSVILLE MD
21536-3320
US

V. Phone/Fax

Practice location:
  • Phone: 301-895-8087
  • Fax: 301-895-8097
Mailing address:
  • Phone: 301-895-8087
  • Fax: 301-895-8097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16149
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: