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NPI Code Detail

MEDICARE: AMANDA L ZEPPA LCSW

MEDICARE: AMANDA L ZEPPA LCSW
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
11041C0700XClinical Social Worker105666AK

General Provider Information

NPI Number : 1750679924
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA L ZEPPA LCSW
Provider Business Mailing Address
First Line : PO BOX 876741
Second Line :
City : WASILLA
State : AK
Zip : 99687-6741
Country : US
Telephone Number : 907-373-4732
Fax Number :
Provider Business Practice Location Address
First Line : 7010 E BOGARD RD
Second Line :
City : WASILLA
State : AK
Zip : 99654-4711
Country : US
Telephone Number : 907-373-4732
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2011
Last Update Date : 12/18/2019

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