Provider Demographics
NPI:1871195818
Name:ZUNK, BETSY
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:
Last Name:ZUNK
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 1:104 W CHESTNUT CT APT C
Mailing Address - Street 2:
Mailing Address - City:WAUSEON
Mailing Address - State:OH
Mailing Address - Zip Code:43567-1354
Mailing Address - Country:US
Mailing Address - Phone:419-490-6740
Mailing Address - Fax:
Practice Address - Street 1:6181 COUNTY ROAD 13
Practice Address - Street 2:
Practice Address - City:WAUSEON
Practice Address - State:OH
Practice Address - Zip Code:43567-9636
Practice Address - Country:US
Practice Address - Phone:419-490-6740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child