Provider Demographics
NPI:1194037895
Name:ZITO, MEGHAN CHANCE (MA)
Entity Type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:CHANCE
Last Name:ZITO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 CANDLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BALLSTON LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12019-1333
Mailing Address - Country:US
Mailing Address - Phone:518-265-9404
Mailing Address - Fax:
Practice Address - Street 1:19 CANDLEWOOD DR
Practice Address - Street 2:
Practice Address - City:BALLSTON LAKE
Practice Address - State:NY
Practice Address - Zip Code:12019-1333
Practice Address - Country:US
Practice Address - Phone:518-265-9404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-09
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool