Healthcare Provider Details

I. General information

NPI: 1194098293
Provider Name (Legal Business Name): SAMANTHIA Z ZOLNOSKI M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2012
Last Update Date: 02/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38746 PLAINVIEW DR
STERLING HEIGHTS MI
48312-1443
US

IV. Provider business mailing address

38746 PLAINVIEW DR
STERLING HEIGHTS MI
48312-1443
US

V. Phone/Fax

Practice location:
  • Phone: 586-871-4957
  • Fax:
Mailing address:
  • Phone: 586-871-4957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: