Provider Demographics
NPI:1578643557
Name:WARDI-ZONNA, KATHERINE LEILA (PHD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LEILA
Last Name:WARDI-ZONNA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:LEILA
Other - Last Name:WARDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:5075 WESTBURY FARMS DR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-6119
Mailing Address - Country:US
Mailing Address - Phone:814-833-4292
Mailing Address - Fax:
Practice Address - Street 1:3939 W RIDGE RD STE A207
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-1886
Practice Address - Country:US
Practice Address - Phone:814-833-2228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS009074L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling