Healthcare Provider Details

I. General information

NPI: 1336624238
Provider Name (Legal Business Name): VALORIE ANNE ZYLA LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2018
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6666 COUNTY ROUTE 11 STE 210
BATH NY
14810-7785
US

IV. Provider business mailing address

6666 COUNTY ROUTE 11 STE 210
BATH NY
14810-7785
US

V. Phone/Fax

Practice location:
  • Phone: 607-346-2966
  • Fax:
Mailing address:
  • Phone: 607-346-2966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number009571-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: