Provider Demographics
NPI:1801322888
Name:ZADROZNY, GINGER (COTA)
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:
Last Name:ZADROZNY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 DARLENE WAY APT C8
Mailing Address - Street 2:
Mailing Address - City:BOULDER CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89005-3348
Mailing Address - Country:US
Mailing Address - Phone:530-554-7912
Mailing Address - Fax:855-232-8604
Practice Address - Street 1:100 VETERANS MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:BOULDER CITY
Practice Address - State:NV
Practice Address - Zip Code:89005-1926
Practice Address - Country:US
Practice Address - Phone:530-554-7912
Practice Address - Fax:855-232-8604
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV18-1434224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant