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General NPI Number Information
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NPI Number | 1861087041
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Entity Type | Organization
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Legal Business Name | ZOLA WELLNESS SERVICES LLC
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Dates
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Enumeration Date | 03/09/2021
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Last Update Date | 03/09/2021
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Provider Practice Location Address
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Address Line | 1287 CHAPEL ST
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City | NEW HAVEN
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State | CT
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Zip | 06511-4514
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Country | US
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Telephone | 203-624-4477
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Fax | 203-848-3096
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Provider Business Mailing Address
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Address Line | 1287 CHAPEL ST
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City | NEW HAVEN
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State | CT
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Zip | 06511-4514
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Country | US
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Telephone | 203-624-4477
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Fax | 203-848-3096
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | MARISSA T. SPENCER
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Credential |
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Telephone | 203-507-9106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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