Provider Demographics
NPI:1346416336
Name:ZWIREK, JENNIFER DOROTHEA
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DOROTHEA
Last Name:ZWIREK
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 1:1201 E THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-5734
Mailing Address - Country:US
Mailing Address - Phone:602-285-0505
Mailing Address - Fax:602-285-1838
Practice Address - Street 1:1201 E THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-5734
Practice Address - Country:US
Practice Address - Phone:602-285-0505
Practice Address - Fax:602-285-1838
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW121251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical