Healthcare Provider Details

I. General information

NPI: 1073951224
Provider Name (Legal Business Name): MALORY M ZAUN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2013
Last Update Date: 02/06/2020
Certification Date: 02/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

524 W PARK AVE
BARBERTON OH
44203-2580
US

IV. Provider business mailing address

87 N CANTON RD
AKRON OH
44305-3838
US

V. Phone/Fax

Practice location:
  • Phone: 330-753-1096
  • Fax: 330-753-1278
Mailing address:
  • Phone: 330-794-4254
  • Fax: 330-794-4262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.1700017-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: