Provider Demographics
NPI:1023717576
Name:ZANZU, MPUTU K
Entity type:Individual
Prefix:
First Name:MPUTU
Middle Name:K
Last Name:ZANZU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7933 JUNE AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-2634
Mailing Address - Country:US
Mailing Address - Phone:651-408-4528
Mailing Address - Fax:
Practice Address - Street 1:7760 FRANCE AVE S FL 11
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55435-5930
Practice Address - Country:US
Practice Address - Phone:612-594-8405
Practice Address - Fax:855-568-2494
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician