Provider Demographics
NPI:1932932795
Name:ZITO, GILLIAN ROSE
Entity type:Individual
Prefix:
First Name:GILLIAN
Middle Name:ROSE
Last Name:ZITO
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 1:9011 HUNTERS POINTE DR
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-9002
Mailing Address - Country:US
Mailing Address - Phone:704-430-8041
Mailing Address - Fax:
Practice Address - Street 1:10210 HICKORYWOOD HILL AVE STE 130
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-3345
Practice Address - Country:US
Practice Address - Phone:704-997-5397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0212301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical