Provider Demographics
NPI:1225448590
Name:ZAMBRANA-GONZALEZ, DANITZA (LICSW)
Entity Type:Individual
Prefix:
First Name:DANITZA
Middle Name:
Last Name:ZAMBRANA-GONZALEZ
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 LORING AVE APT A84
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-4288
Mailing Address - Country:US
Mailing Address - Phone:978-876-8127
Mailing Address - Fax:
Practice Address - Street 1:20 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1201
Practice Address - Country:US
Practice Address - Phone:978-744-7905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-07
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health