Provider Demographics
NPI:1366677460
Name:OKOLIE, ZOE K
Entity Type:Individual
Prefix:
First Name:ZOE
Middle Name:K
Last Name:OKOLIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ZOE
Other - Middle Name:K
Other - Last Name:RADEMEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:340 TURNPIKE ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-2700
Mailing Address - Country:US
Mailing Address - Phone:781-619-1523
Mailing Address - Fax:
Practice Address - Street 1:340 TURNPIKE ST
Practice Address - Street 2:SUITE 1
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2700
Practice Address - Country:US
Practice Address - Phone:781-619-1523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-19
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1171281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical