MEDICARE: AMANDA ZEITEL

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	101YP2500X	Professional Counselor	6461	CT

General Provider Information

NPI Number	:	1568148823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA ZEITEL

Provider Business Mailing Address
First Line	:	75 CADBURY LN
Second Line	:
City	:	SOUTH WINDSOR
State	:	CT
Zip	:	06074-2270
Country	:	US
Telephone Number	:	860-810-9716
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 CADBURY LN
Second Line	:
City	:	SOUTH WINDSOR
State	:	CT
Zip	:	06074-2270
Country	:	US
Telephone Number	:	860-810-9716
Fax Number	:

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

Provider Enumeration Date	:	06/22/2023
Last Update Date	:	06/22/2023

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Directions to “ AMANDA ZEITEL ” Practice Location

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