Healthcare Provider Details

I. General information

NPI: 1750737789
Provider Name (Legal Business Name): VANESSA ZITO CMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2016
Last Update Date: 06/09/2021
Certification Date: 02/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 E PIONEER RD BLDG 103
DRAPER UT
84020-1881
US

IV. Provider business mailing address

567 E DRAPER WOODS WAY
DRAPER UT
84020-7625
US

V. Phone/Fax

Practice location:
  • Phone: 801-701-7339
  • Fax:
Mailing address:
  • Phone: 801-918-5282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1034147-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: