Healthcare Provider Details

I. General information

NPI: 1295661080
Provider Name (Legal Business Name): LILLIAN PAULINE ZOLL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NYX ZOLL

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15496 GARY LN
BATH MI
48808-8739
US

IV. Provider business mailing address

15496 GARY LN
BATH MI
48808-8739
US

V. Phone/Fax

Practice location:
  • Phone: 517-706-1884
  • Fax:
Mailing address:
  • Phone: 517-706-1884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: