MEDICARE: MRS. LAURA VANESA ZVIOVICH LPC, NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	3075	GA

General Provider Information

NPI Number	:	1053667311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LAURA VANESA ZVIOVICH LPC, NCC

Provider Business Mailing Address
First Line	:	2050 ROSWELL RD
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-3801
Country	:	US
Telephone Number	:	678-784-4293
Fax Number	:

Provider Business Practice Location Address
First Line	:	2050 ROSWELL RD
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-3801
Country	:	US
Telephone Number	:	678-784-4293
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2012
Last Update Date	:	11/04/2014

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