Provider Demographics
NPI:1376675025
Name:ZIENTARA, JANE ELIZABETH (MA, CCC - SLP)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:ELIZABETH
Last Name:ZIENTARA
Suffix:
Gender:F
Credentials:MA, CCC - SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 MICKLEY RD
Mailing Address - Street 2:APT. BB2-2
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-5000
Mailing Address - Country:US
Mailing Address - Phone:610-434-3170
Mailing Address - Fax:
Practice Address - Street 1:900 MICKLEY RD
Practice Address - Street 2:APT. BB2-2
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052-5000
Practice Address - Country:US
Practice Address - Phone:610-434-3170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL005506L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1013147700001Medicaid