Healthcare Provider Details

I. General information

NPI: 1548464712
Provider Name (Legal Business Name): SHAUNA DAVIS ZITTING L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 04/03/2023
Certification Date: 04/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N MALL DR STE 102
SAINT GEORGE UT
84790-7302
US

IV. Provider business mailing address

284 W 1725 S
WASHINGTON UT
84780-8000
US

V. Phone/Fax

Practice location:
  • Phone: 435-932-3672
  • Fax:
Mailing address:
  • Phone: 435-215-6764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5924191-3501
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number59241913502
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: