Basic Information
| Provider Information | |||||||||
| NPI: | 1568935625 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZAVALA | ||||||||
| FirstName: | NORA | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MSW, LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11156 CANAL RD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452415815 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137726166 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 11156 CANAL RD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137726166 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2019 | ||||||||
| LastUpdateDate: | 11/07/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | S.1201493 | OH | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 104100000X | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.