Provider Demographics
NPI:1477287985
Name:HAZLETT, ZAKARIAH KENT
Entity type:Individual
Prefix:
First Name:ZAKARIAH
Middle Name:KENT
Last Name:HAZLETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 RIVERSANDS RD
Mailing Address - Street 2:
Mailing Address - City:MOAB
Mailing Address - State:UT
Mailing Address - Zip Code:84532-2032
Mailing Address - Country:US
Mailing Address - Phone:435-260-0290
Mailing Address - Fax:
Practice Address - Street 1:519 W STATE RD STE 102
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062-2158
Practice Address - Country:US
Practice Address - Phone:385-312-9844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-11
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health