Healthcare Provider Details

I. General information

NPI: 1982052056
Provider Name (Legal Business Name): PATRICIA ZAPF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2016
Last Update Date: 12/09/2022
Certification Date: 12/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W RIVER DR
WEST BEND WI
53090-1518
US

IV. Provider business mailing address

400 W RIVER DR
WEST BEND WI
53090-1518
US

V. Phone/Fax

Practice location:
  • Phone: 623-344-3402
  • Fax:
Mailing address:
  • Phone: 262-334-4340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3031
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: