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General NPI Number Information
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NPI Number | 1790262624
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Entity Type | Organization
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Legal Business Name | LISA S. ZOLL
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Dates
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Enumeration Date | 07/24/2018
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Last Update Date | 07/24/2018
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Provider Practice Location Address
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Address Line | 2601 N FRONT ST STE 102
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City | HARRISBURG
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State | PA
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Zip | 17110-1123
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Country | US
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Telephone | 717-571-6459
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 CLARENDON ST
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City | CAMP HILL
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State | PA
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Zip | 17011-3828
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Country | US
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Telephone | 717-571-6459
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | LISA S ZOLL
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Credential | LCSW
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Telephone | 717-571-6459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW015572
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License Number State | PA
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