Healthcare Provider Details

I. General information

NPI: 1053011668
Provider Name (Legal Business Name): VANESSA ZAPATA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2023
Last Update Date: 03/15/2023
Certification Date: 03/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 N 2ND ST
WORMLEYSBURG PA
17043-1104
US

IV. Provider business mailing address

325 N 2ND ST
WORMLEYSBURG PA
17043-1104
US

V. Phone/Fax

Practice location:
  • Phone: 844-588-4222
  • Fax: 717-775-3443
Mailing address:
  • Phone: 844-588-4222
  • Fax: 717-775-3443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: