Provider Demographics
NPI:1881179141
Name:ZODY, ZANITA BOHEA (PHD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:ZANITA
Middle Name:BOHEA
Last Name:ZODY
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2830 YORK ST
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-3837
Mailing Address - Country:US
Mailing Address - Phone:503-539-9999
Mailing Address - Fax:
Practice Address - Street 1:415 N STATE ST
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97034-3240
Practice Address - Country:US
Practice Address - Phone:503-912-8190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT-1336106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist