Healthcare Provider Details

I. General information

NPI: 1881513489
Provider Name (Legal Business Name): ALLIVIA A ZOERN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2012 CHERRY HILL DR STE 102
COLUMBIA MO
65203-5882
US

IV. Provider business mailing address

1609 WINDSOR ST APT 8
COLUMBIA MO
65201-5773
US

V. Phone/Fax

Practice location:
  • Phone: 573-891-1330
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2024016109
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: