Healthcare Provider Details

I. General information

NPI: 1124896824
Provider Name (Legal Business Name): JODIE MARIE ZOLL LMT, HHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2023
Last Update Date: 12/13/2023
Certification Date: 12/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4136 TOULOUSE ST APT 2
NEW ORLEANS LA
70119-4732
US

IV. Provider business mailing address

4136 TOULOUSE ST APT 2
NEW ORLEANS LA
70119-4732
US

V. Phone/Fax

Practice location:
  • Phone: 504-352-8783
  • Fax:
Mailing address:
  • Phone: 504-352-8783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number1070123
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: