Provider Demographics
NPI:1306835269
Name:ZAVARELLA, ROSANNA O (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROSANNA
Middle Name:O
Last Name:ZAVARELLA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24100 CHAGRIN BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5545
Mailing Address - Country:US
Mailing Address - Phone:216-321-3025
Mailing Address - Fax:216-831-1269
Practice Address - Street 1:24100 CHAGRIN BLVD STE 140
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5545
Practice Address - Country:US
Practice Address - Phone:216-321-3025
Practice Address - Fax:216-831-1269
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-13
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.5150103T00000X
OHOH5150103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2271018Medicaid
OH2271018Medicaid