Provider Demographics
NPI:1780337451
Name:ZOFNASS, JOAN S (DSW)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:S
Last Name:ZOFNASS
Suffix:
Gender:F
Credentials:DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 212
Mailing Address - Street 2:
Mailing Address - City:RYE BEACH
Mailing Address - State:NH
Mailing Address - Zip Code:03871-0212
Mailing Address - Country:US
Mailing Address - Phone:917-513-3126
Mailing Address - Fax:
Practice Address - Street 1:693 CENTRAL RD
Practice Address - Street 2:
Practice Address - City:RYE BEACH
Practice Address - State:NH
Practice Address - Zip Code:03871-9010
Practice Address - Country:US
Practice Address - Phone:917-513-3126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRO175041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical