Provider Demographics
NPI:1578960662
Name:ZIRKIND, ALIZA (LGPC)
Entity Type:Individual
Prefix:
First Name:ALIZA
Middle Name:
Last Name:ZIRKIND
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6707 WHITESTONE RD # MD
Mailing Address - Street 2:
Mailing Address - City:GWYNN OAK
Mailing Address - State:MD
Mailing Address - Zip Code:21207-4106
Mailing Address - Country:US
Mailing Address - Phone:410-265-8737
Mailing Address - Fax:410-265-1258
Practice Address - Street 1:6707 WHITESTONE RD # MD
Practice Address - Street 2:
Practice Address - City:GWYNN OAK
Practice Address - State:MD
Practice Address - Zip Code:21207-4106
Practice Address - Country:US
Practice Address - Phone:410-265-8737
Practice Address - Fax:410-265-1258
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-04
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP5162251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management