Provider Demographics
NPI:1467911511
Name:GILENO, ZANETA MICHELLE
Entity Type:Individual
Prefix:
First Name:ZANETA
Middle Name:MICHELLE
Last Name:GILENO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5414 W DAYBREAK PKWY # C4-224
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84009-5904
Mailing Address - Country:US
Mailing Address - Phone:385-247-8630
Mailing Address - Fax:
Practice Address - Street 1:5414 W DAYBREAK PKWY # C4-224
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84009-5904
Practice Address - Country:US
Practice Address - Phone:385-247-8630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-18
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11024391-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical