Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | 10875901 | GA |
N | 2080A0000X | Adolescent Medicine | 002234 | GA |
NPI | 1316051030 |
---|---|
Provider Name | Mrs. Deborah Lynn Zito |
First Address | St Simons Island, GA 31522-1013 |
Second Address | St Simons Island, GA 31522-5644 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 01/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002234 | GA LICENSE (01) | GA |
100001874A | (05) | GA |