Provider Demographics
NPI:1639780398
Name:ZAVETZ, JENNA (OTR)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:ZAVETZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8470 SERRANO CIR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-8088
Mailing Address - Country:US
Mailing Address - Phone:321-609-1396
Mailing Address - Fax:
Practice Address - Street 1:1994 GALLATIN PIKE N STE 202
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-2024
Practice Address - Country:US
Practice Address - Phone:615-596-1830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6606225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist