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General NPI Number Information
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NPI Number | 1609634682
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Entity Type | Individual
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Provider Name | ZACHARY C. SOSA CADC
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Gender | Male
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Dates
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Enumeration Date | 03/13/2024
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Last Update Date | 03/13/2024
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Provider Practice Location Address
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Address Line | 430 SOUTHGATE AVE
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City | IOWA CITY
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State | IA
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Zip | 52240-4425
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Country | US
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Telephone | 319-351-4357
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Fax |
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Provider Business Mailing Address
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Address Line | 876 BOSTON WAY APT 4
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City | CORALVILLE
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State | IA
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Zip | 52241-3123
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Country | US
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Telephone | 309-271-9966
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 24013
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License Number State | IA
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