Provider Demographics
NPI:1265982508
Name:ZIERTEN, RENEE JONELL (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:JONELL
Last Name:ZIERTEN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 RICE AVE
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-1709
Mailing Address - Country:US
Mailing Address - Phone:617-771-1451
Mailing Address - Fax:
Practice Address - Street 1:43 RICE AVE
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-1709
Practice Address - Country:US
Practice Address - Phone:617-771-1451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3485224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant