Healthcare Provider Details

I. General information

NPI: 1285011817
Provider Name (Legal Business Name): JENNIFER ANN ZAPOLSKI MS CCC/SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2015
Last Update Date: 05/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 MAIN ST
EAST HARTFORD CT
06108-3115
US

IV. Provider business mailing address

83 GEORGE WOOD RD
SOMERS CT
06071-1519
US

V. Phone/Fax

Practice location:
  • Phone: 860-289-2791
  • Fax:
Mailing address:
  • Phone: 860-289-2791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number002945
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: