Provider Demographics
NPI:1437746393
Name:ZOROSAK, TABITHA NICOLE
Entity Type:Individual
Prefix:MRS
First Name:TABITHA
Middle Name:NICOLE
Last Name:ZOROSAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TABITHA
Other - Middle Name:NICOLE
Other - Last Name:FOWKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1037 COMPASS CIR
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-2788
Mailing Address - Country:US
Mailing Address - Phone:724-834-1144
Mailing Address - Fax:
Practice Address - Street 1:2222 BREAKNECK RD
Practice Address - Street 2:
Practice Address - City:WHITE
Practice Address - State:PA
Practice Address - Zip Code:15490-1081
Practice Address - Country:US
Practice Address - Phone:724-961-0002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)