Provider Demographics
NPI:1003402066
Name:ZIENTEK, DONNA SUE
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:SUE
Last Name:ZIENTEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8609 WATERFORD RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22308-2352
Mailing Address - Country:US
Mailing Address - Phone:910-554-5944
Mailing Address - Fax:
Practice Address - Street 1:8609 WATERFORD RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22308-2352
Practice Address - Country:US
Practice Address - Phone:910-554-5944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040051871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical