Provider Demographics
NPI:1104332832
Name:BLIZZARD, ZURI
Entity type:Individual
Prefix:
First Name:ZURI
Middle Name:
Last Name:BLIZZARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ZURI
Other - Middle Name:
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5541 PONY FARM DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-3182
Mailing Address - Country:US
Mailing Address - Phone:804-591-8536
Mailing Address - Fax:
Practice Address - Street 1:12318 BOYDTON PLANK RD
Practice Address - Street 2:
Practice Address - City:DINWIDDIE
Practice Address - State:VA
Practice Address - Zip Code:23841-2454
Practice Address - Country:US
Practice Address - Phone:804-591-5836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor