Provider Demographics
NPI:1356500359
Name:ZARZAUR, MARLO CARNEY (EDD)
Entity Type:Individual
Prefix:DR
First Name:MARLO
Middle Name:CARNEY
Last Name:ZARZAUR
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2409 PARMENTER ST APT 425
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-2687
Mailing Address - Country:US
Mailing Address - Phone:901-734-1778
Mailing Address - Fax:
Practice Address - Street 1:6502 GRAND TETON PLZ STE 204
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1047
Practice Address - Country:US
Practice Address - Phone:608-338-1786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-04
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC2008101Y00000X
TN2208101YM0800X
NC4394101YM0800X
TNLPC2208101YP2500X
TN101YS0200X
WI10746-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool