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General NPI Number Information
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NPI Number | 1043611585
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Entity Type | Individual
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Provider Name | VANICE ZENON
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Gender | Female
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Dates
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Enumeration Date | 09/15/2014
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Last Update Date | 09/15/2014
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Provider Practice Location Address
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Address Line | 843 MILLING AVE
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City | LULING
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State | LA
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Zip | 70070-4442
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Country | US
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Telephone | 504-575-3712
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Fax | 504-575-3691
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Provider Business Mailing Address
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Address Line | 2526 STANTON LN
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City | SLIDELL
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State | LA
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Zip | 70460-3924
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Country | US
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Telephone | 985-641-4061
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Fax | 504-575-3691
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 7440
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License Number State | LA
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