Provider Demographics
NPI:1376663104
Name:ZABRISKIE, GAYE DEEN (LPN)
Entity Type:Individual
Prefix:
First Name:GAYE
Middle Name:DEEN
Last Name:ZABRISKIE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:UT
Mailing Address - Zip Code:84647-1331
Mailing Address - Country:US
Mailing Address - Phone:435-462-2416
Mailing Address - Fax:435-462-9350
Practice Address - Street 1:125 S STATE ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:UT
Practice Address - Zip Code:84647-1563
Practice Address - Country:US
Practice Address - Phone:435-462-2421
Practice Address - Fax:435-462-0278
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT284630-3101101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health