Provider Demographics
NPI:1689047540
Name:ZION, MONICA (DTR, RLC, IBCLC)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:ZION
Suffix:
Gender:F
Credentials:DTR, RLC, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 W JERSEY WAY
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85143-4873
Mailing Address - Country:US
Mailing Address - Phone:480-710-1139
Mailing Address - Fax:
Practice Address - Street 1:304 W JERSEY WAY
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85143-4873
Practice Address - Country:US
Practice Address - Phone:480-710-1139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-01
Last Update Date:2015-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ86042252136A00000X
AZL-81967174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No136A00000XDietary & Nutritional Service ProvidersDietetic Technician, Registered