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General NPI Number Information
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NPI Number | 1356908586
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Entity Type | Individual
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Provider Name | AMY ELIZABETH VANZANDT LMHC
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Gender | Female
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Dates
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Enumeration Date | 05/23/2019
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Last Update Date | 05/23/2019
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Provider Practice Location Address
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Address Line | 2711 N 21ST ST
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City | TACOMA
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State | WA
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Zip | 98406-7519
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Country | US
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Telephone | 253-879-3804
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Fax |
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Provider Business Mailing Address
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Address Line | 2309 S 8TH ST
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City | TACOMA
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State | WA
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Zip | 98405-3018
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Country | US
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Telephone | 253-970-0470
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH60964775
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License Number State | WA
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