Provider Demographics
NPI:1124613617
Name:DELZEITH, JESSICA SUE
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:SUE
Last Name:DELZEITH
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 1:1221 5TH ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-6541
Mailing Address - Country:US
Mailing Address - Phone:419-733-2116
Mailing Address - Fax:
Practice Address - Street 1:304 HILTY DR
Practice Address - Street 2:
Practice Address - City:PANDORA
Practice Address - State:OH
Practice Address - Zip Code:45877-9476
Practice Address - Country:US
Practice Address - Phone:419-384-3218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA005897224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant