Provider Demographics
NPI:1447803515
Name:HENDERSHOT, ZOEY NICOLE
Entity Type:Individual
Prefix:
First Name:ZOEY
Middle Name:NICOLE
Last Name:HENDERSHOT
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 1:1200 E WHEELING AVE
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-2510
Mailing Address - Country:US
Mailing Address - Phone:740-432-1800
Mailing Address - Fax:
Practice Address - Street 1:1200 E WHEELING AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-2510
Practice Address - Country:US
Practice Address - Phone:740-432-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator