Provider Demographics
NPI:1861566887
Name:ZUMOFF, MARY MARGARET (MED)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:MARGARET
Last Name:ZUMOFF
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 E WATSON DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3034
Mailing Address - Country:US
Mailing Address - Phone:480-730-5801
Mailing Address - Fax:
Practice Address - Street 1:7272 E INDIAN SCHOOL RD STE 415
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-3952
Practice Address - Country:US
Practice Address - Phone:480-333-5504
Practice Address - Fax:480-333-5501
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC294101YA0400X
AZLPC0551101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health