MEDICARE: KATHLEEN L ZITOWITZ 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
1	1041C0700X	Clinical Social Worker	6493	FL

General Provider Information

NPI Number	:	1760464002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN L ZITOWITZ LCSW

Provider Business Mailing Address
First Line	:	1466 MARLIN ST
Second Line	:
City	:	NOKOMIS
State	:	FL
Zip	:	34275-2320
Country	:	US
Telephone Number	:	941-321-2214
Fax Number	:

Provider Business Practice Location Address
First Line	:	1466 MARLIN ST
Second Line	:
City	:	NOKOMIS
State	:	FL
Zip	:	34275-2320
Country	:	US
Telephone Number	:	941-321-2214
Fax Number	:

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

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	07/08/2007

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