Individual
AVI-NATAN ZADAKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
777 29TH ST STE 500, BOULDER, CO 80303-2357
(763) 442-7238
Mailing address
569 WILLOUGHBY WAY E, HOPKINS, MN 55305-5414
(763) 442-7238
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
09928781
CO
1041C0700X
Clinical Social Worker
28038
MN
Other
Enumeration date
12/04/2020
Last updated
02/27/2023
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