Provider Demographics
NPI:1790320190
Name:LAOTA, ZOBAIDA (LCMHCA)
Entity Type:Individual
Prefix:
First Name:ZOBAIDA
Middle Name:
Last Name:LAOTA
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3214 BRASSFIELD RD APT 6202
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-9454
Mailing Address - Country:US
Mailing Address - Phone:919-265-8192
Mailing Address - Fax:
Practice Address - Street 1:3214 BRASSFIELD RD APT 6202
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-9454
Practice Address - Country:US
Practice Address - Phone:919-265-8192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-10
Last Update Date:2020-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA12475101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional