Individual
ZOE LOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2111 W US HIGHWAY 377, GRANBURY, TX 76048-5627
(817) 573-6002
(817) 573-6009
Mailing address
PO BOX 2603, FORT WORTH, TX 76113-2603
(817) 569-4300
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13026
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148686201
—
TX
Enumeration date
09/17/2015
Last updated
05/11/2021
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