Provider Demographics
NPI:1598962276
Name:ZAVODNY, DENIS L (PHD, BCBA)
Entity Type:Individual
Prefix:DR
First Name:DENIS
Middle Name:L
Last Name:ZAVODNY
Suffix:
Gender:M
Credentials:PHD, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 PEACHTREE ST NW APT 906
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-2355
Mailing Address - Country:US
Mailing Address - Phone:850-510-4007
Mailing Address - Fax:
Practice Address - Street 1:32 PEACHTREE ST NW APT 906
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-2355
Practice Address - Country:US
Practice Address - Phone:850-510-4007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPY002510103TC0700X
FLPY6321103TC0700X
AL1165103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical