Healthcare Provider Details

I. General information

NPI: 1447148218
Provider Name (Legal Business Name): ELIZABETH FRANCES ZAZA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 S 80TH ST
MILWAUKEE WI
53214-1430
US

IV. Provider business mailing address

160 S 80TH ST
MILWAUKEE WI
53214-1430
US

V. Phone/Fax

Practice location:
  • Phone: 414-477-7362
  • Fax:
Mailing address:
  • Phone: 414-477-7362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number2620242
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberSP0000001118786
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number682896
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: