Provider Demographics
NPI:1972940443
Name:LEVI, ZIPPORAH LEE
Entity type:Individual
Prefix:MRS
First Name:ZIPPORAH
Middle Name:LEE
Last Name:LEVI
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ZIPPORAH
Other - Middle Name:LEE
Other - Last Name:LEVI-SHACKLEFORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9536 SHEPTON CIR
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-5537
Mailing Address - Country:US
Mailing Address - Phone:804-218-6780
Mailing Address - Fax:
Practice Address - Street 1:4100 PRICE CLUB BLVD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-3379
Practice Address - Country:US
Practice Address - Phone:804-674-8888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst