Provider Demographics
NPI:1487795522
Name:ZOTTER, DEANNE U (PHD)
Entity type:Individual
Prefix:DR
First Name:DEANNE
Middle Name:U
Last Name:ZOTTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:DEANNE
Other - Middle Name:ZOTTER
Other - Last Name:BONIFAZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:291 DRESSAGE CT
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-2365
Mailing Address - Country:US
Mailing Address - Phone:484-947-3268
Mailing Address - Fax:
Practice Address - Street 1:5 CHRISTY DR
Practice Address - Street 2:SUITE 102
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-9682
Practice Address - Country:US
Practice Address - Phone:484-947-3268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007150L103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist