Individual
KELLY R ZOLLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
12353 IMPERIAL HWY, NORWALK, CA 90650-8305
(562) 484-3385
(562) 484-0269
Mailing address
12353 IMPERIAL HWY, NORWALK, CA 90650-8305
(562) 484-3385
(562) 484-0269
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
30755
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1512013461
—
CA
Enumeration date
06/09/2009
Last updated
06/09/2009
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