Individual
DONALD ZALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
86 BAKER AVENUE EXTENSION, CONCORD, MA 01742-2188
(978) 287-9380
(978) 287-6199
Mailing address
147 MILK ST, PROVIDER ENROLLMENT, BOSTON, MA 02109-4806
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
103183
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01509
BLUE CROSS
MA
Enumeration date
07/26/2006
Last updated
03/06/2009
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